Publicações de Brian HIBLER (47)

Litigation Arising From Minimally Invasive Cosmetic Procedures: A Review of the Literature.

Dec, 2021

Minimally invasive cosmetic procedures are on the rise. To meet this rising demand, increasing numbers of physicians and nonphysicians are performing these procedures. Understanding malpractice trends and reasons for litigation in cosmetic medicine is important to establish safeguards for patient care and minimize liability. Ler mais

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Restorative oncodermatology: Diagnosis and management of dermatologic sequelae from cancer therapies.

Sep, 2021

The long-term survival of patients with cancer has risen dramatically during the last few decades. Despite this remarkable success, the same treatments that have enabled cure or remission often secondarily affect the skin, hair, and nails. Conditions including scarring, striae distensae, persistent alopecia, pigmentary changes, nail alterations, chronic radiation dermatitis, and radiation fibrosis have been associated with anxiety, depression, decreased quality of life, and impaired function. These dermatologic changes are cosmetically disfiguring, may limit activities, and are a visual reminder of past illness. Interventions toward improving these untoward sequelae and restoring the appearance and function of skin and appendages are critical for normalization and may contribute to improved quality of life in cancer survivors. Here, we outline dermatologic sequelae of cancer therapies with a review of medical and procedural treatment strategies to restore dermatologic health in the survivorship population. Ler mais

Journal of the American Academy of Dermatology

Clinical size is a poor predictor of invasion in melanoma of the lentigo maligna type.

May, 2021

There are no well-defined clinical factors to predict the risk of occult invasion in melanoma of the lentigo maligna type (LM) before complete histopathologic analysis. Ler mais

Journal of the American Academy of Dermatology Carregar mais  

Treatment of Extramammary Paget Disease and the Role of Reflectance Confocal Microscopy: A Prospective Study.

Apr, 2021

Extramammary Paget disease (EMPD) poses treatment challenges. Invasive and noninvasive treatment modalities exist with variable success reported. Reflectance confocal microscopy (RCM) is emerging as an adjuvant diagnostic tool. Ler mais

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Treatment of severe cutaneous adverse reaction with tocilizumab.

Oct, 2020

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The British journal of dermatology

Lentigo Maligna Margin Template for Surgical Excision Using Reflectance Confocal Microscopy and a Transparent Adhesive Dressing.

Jul, 2020

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Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Treatment of Facial Lipoatrophy Secondary to Subcutaneous Panniculitis-Like T-Cell Lymphoma.

May, 2020

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Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Using a metallic ink pen to assist in the demarcation of skin lesions under reflectance confocal microscopy.

Dec, 2019

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Journal of the American Academy of Dermatology

Reflectance confocal microscopy-guided carbon dioxide laser ablation of low-risk basal cell carcinomas: A prospective study.

Oct, 2019

Basal cell carcinoma (BCC) treatment modalities can be stratified by tumor subtype and recurrence risk. The main limitation of nonsurgical treatment modalities is the lack of histopathologic confirmation. Reflectance confocal microscopy (RCM) is a noninvasive imaging device that provides quasihistologic images. Ler mais

Journal of the American Academy of Dermatology

Beach Bummer: A Recurrent Pruritic Buttocks Eruption Following Travel.

Aug, 2019

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The American journal of medicine

Rapidly enlarging neoplasm on the face.

Jun, 2019

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Cutis

Melanoma and melanoma in-situ diagnosis after excision of atypical intraepidermal melanocytic proliferation: A retrospective cross-sectional analysis.

May, 2019

There is little evidence to guide surgical management of biopsies yielding the histologic descriptor atypical intraepidermal melanocytic proliferation (AIMP). Ler mais

Journal of the American Academy of Dermatology

Sonic Hedgehog pathway inhibitors: from clinical trials to clinical practice.

May, 2019

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The British journal of dermatology

Nonphysician Practice of Cosmetic Dermatology: A Patient and Physician Perspective of Outcomes and Adverse Events.

Apr, 2019

Nonphysicians are expanding practice into specialty medicine. There are limited studies on patient and physician perspectives as well as safety outcomes regarding the nonphysician practice of cosmetic procedures. Ler mais

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Basal cell carcinoma: Contemporary approaches to diagnosis, treatment, and prevention.

Feb, 2019

As the most common human cancer worldwide and continuing to increase in incidence, basal cell carcinoma is associated with significant morbidity and cost. Continued advances in research have refined both our insight and approach to this seemingly ubiquitous disease. This 2-part continuing medical education series provides a comprehensive and contemporary review of basal cell carcinoma. The second article in this series will present both the current standard of care and newly developed approaches to diagnosis, treatment, and prevention of this disease. Ler mais

Journal of the American Academy of Dermatology

Basal cell carcinoma: Epidemiology; pathophysiology; clinical and histological subtypes; and disease associations.

Feb, 2019

As the most common human cancer worldwide and continuing to increase in incidence, basal cell carcinoma is associated with significant morbidity and cost. Continued advances in research have refined both our insight and approach to this seemingly ubiquitous disease. This 2-part continuing medical education article will provide a comprehensive and contemporary review of basal cell carcinoma. The first article in this series describes our current understanding of this disease regarding epidemiology, cost, clinical and histopathologic presentations, carcinogenesis, natural history, and disease associations. Ler mais

Journal of the American Academy of Dermatology

Reconstruction of a Combined Nose and Cheek Defect.

Nov, 2018

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Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Analysis of Dermatologic Procedures Billed Independently by Non-Physician Practitioners in the United States.

Sep, 2018

Non-physician practitioners (NPPS), including nurse practitioners (NPs) and physician assistants (PAs) are expanding their scope of practice outside of primary care and performing more procedures in dermatology. Ler mais

Journal of the American Academy of Dermatology

Facial swelling and foreign body granulomatous reaction to hyaluronic acid filler in the setting of tyrosine kinase inhibitor therapy.

Jun, 2018

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Journal of the European Academy of Dermatology and Venereology : JEADV

Atypical Melanocytic Proliferations: A Review of the Literature.

Feb, 2018

Ambiguous histopathologic diagnoses represent a challenge for clinicians because of a lack of definitive diagnosis and related uncertainty about management. Ler mais

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Intraoral Laser Hair Removal of a Palate Free Flap: Tips and Technique.

Jan, 2018

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Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Lentigo maligna melanoma with a history of cosmetic treatment: Prevalence, surgical outcomes and considerations.

Nov, 2017

Lentigo maligna (LM) is melanoma in situ on sun-damaged skin and presents diagnostic challenges due to overlapping features with benign pigmented lesions. Cosmetic treatments may be inadvertently performed on LM. The aim of this study is to estimate the prevalence of LM with prior cosmetic treatment, and evaluate surgical outcomes. Ler mais

Lasers in surgery and medicine

Handheld Reflectance Confocal Microscopy for the Detection of Recurrent Extramammary Paget Disease.

Jul, 2017

Extramammary Paget disease (EMPD) is commonly refractory to surgical and nonsurgical therapies. Identifying recurrent or persistent EMPD is challenging because the disease is multifocal, and multiple blind scouting biopsies are usually performed in this setting. Handheld reflectance confocal microscopy (HRCM) has been used to diagnose and map primary EMPD and therefore may be used to identify EMPD recurrences. Ler mais

JAMA dermatology

Locally Recurrent Lentigo Maligna and Lentigo Maligna Melanoma: Characteristics and Time to Recurrence After Surgery.

Jun, 2017

Various studies have reported local recurrence (LR) rates after surgical treatment of lentigo maligna (LM) and lentigo maligna melanoma (LMM). However, the time to LR of LM/LMM is not currently known, as few studies report time to LR and have long-term follow-up. Ler mais

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Handheld reflectance confocal microscopy to aid in the management of complex facial lentigo maligna.

May, 2017

Diagnosis and management of lentigo maligna (LM) and LM melanoma (LMM) is challenging. Novel noninvasive imaging technologies such as reflectance confocal microscopy (RCM) have advanced the ability to better diagnose and monitor challenging lesions. In addition, the new handheld RCM (HRCM) together with the use of videomosaics has allowed an accurate evaluation of large lesions in concave/convex areas of the body (eg, the face). Herein, we review the impact of HRCM in the detection, treatment decision-making, and monitoring of 5 cases of complex facial LM/LMM. In the cases presented, HRCM enabled the detection of subclinical margins, presence of invasion, detection of persistence/recurrence, and monitoring of surgical and nonsurgical therapies. In this preliminary report, our results suggest that HRCM is a versatile ancillary tool in pretreatment decision-making, intraoperative surgical mapping, and posttreatment monitoring of complex facial LM/LMM. Ler mais

Cutis

Metastatic cutaneous apocrine carcinoma: Multidisciplinary approach achieving complete response with adjuvant chemoradiation.

May, 2017

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JAAD case reports

Antimicrobial Prophylaxis for Full-Face Laser Resurfacing in Transplant Recipients.

Apr, 2017

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Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

A Woman With Recurrent Facial Ulcers.

Feb, 2017

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The American Journal of dermatopathology

A Woman With Recurrent Facial Ulcers.

Feb, 2017

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The American Journal of dermatopathology

Bilateral symmetric onycholysis of distal fingernails.

Jan, 2017

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Cutis

Primary cutaneous adenosquamous carcinoma of the penis: the first characterization of HPV status in this rare and diagnostically challenging entity with review of glandular carcinomas of the penis.

Dec, 2016

Glandular and pseudoglandular tumors of the penile skin are extremely uncommon and can present diagnostic challenges. Primary adenosquamous carcinoma of the penis is an extremely rare tumor, composed of distinct areas of malignant squamous and glandular cells, making it a diagnostically challenging entity. The World Health Organization (WHO) recognizes several subtypes of squamous cell carcinoma (SCC), each with its own distinctive pathologic appearance, clinical associations and prognosis. Among these variants is the exceedingly uncommon adenosquamous carcinoma (ASC), representing 1%-2% of all SCC of the penis. Recent large studies have interrogated the presence of human papillomavirus (HPV) in malignant penile tumors and have shown specific morphologic patterns and clinical presentations to associate with HPV status. However, given the rarity of the adenosquamous variant of SCC, it has largely been excluded from these studies. The glandular components of these lesions can present a confusing appearance, particularly when a large tumor is represented on a small biopsy. Here we describe a difficult histologic presentation of this rare tumor, with the first published characterization of the HPV status of this subtype. This case represents a distinctly unusual case of metastatic HPV-positive primary cutaneous adenosquamous carcinoma of the penis. Ler mais

Journal of cutaneous pathology

Reconstruction of a Lower Conchal Bowl Defect.

Oct, 2016

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Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Carbon dioxide laser ablation of basal cell carcinoma with visual guidance by reflectance confocal microscopy: a proof-of-principle pilot study.

Jun, 2016

Laser ablation is an alternative, nonsurgical treatment modality for low-risk basal cell carcinoma (BCC). However, lack of confirmative tumour destruction or residual tumour presence has been a limiting factor to its adoption. Reflectance confocal microscopy (RCM) provides noninvasive, cellular-level resolution imaging of the skin and is capable of identifying tumour. Ler mais

The British journal of dermatology

Painful Violaceous Purpura on a 44-Year-Old Woman.

Jun, 2016

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The American journal of medicine

Concordance of handheld reflectance confocal microscopy (RCM) with histopathology in the diagnosis of lentigo maligna (LM): A prospective study.

Jun, 2016

Reflectance confocal microscopy (RCM) provides real-time noninvasive imaging of cell structure and may be useful in diagnosing lentigo maligna (LM). Few studies have compared performance of RCM with histopathology in diagnosing LM, and specific features influencing RCM interpretation are not well described. Ler mais

Journal of the American Academy of Dermatology

Current state of imaging in dermatology.

Mar, 2016

Medical imaging has dramatically transformed the practice of medicine, especially the field of dermatology. Imaging is used to facilitate the transfer of information between providers, document cutaneous disease, assess response to therapy, and plays a crucial role in monitoring and diagnosing skin cancer. Advancements in imaging technology and overall improved quality of imaging have augmented the utility of photography. We provide an overview of current imaging technologies used in dermatology with a focus on their role in skin cancer diagnosis. Future technologies include three-dimensional, total-body photography, mobile smartphone applications, and computerassisted diagnostic devices. With these advancements, we are better equipped to capture and monitor skin conditions longitudinally and achieve improved diagnostic accuracy of skin cancer. Ler mais

Seminars in cutaneous medicine and surgery

Computer-assisted diagnosis of melanoma.

Mar, 2016

The computer-assisted diagnosis of melanoma is an exciting area of research where imaging techniques are combined with diagnostic algorithms in an attempt to improve detection and outcomes for patients with skin lesions suspicious for malignancy. Once an image has been acquired, it undergoes a processing pathway which includes preprocessing, enhancement, segmentation, feature extraction, feature selection, change detection, and ultimately classification. Practicality for everyday clinical use remains a vital question. A successful model must obtain results that are on par or outperform experienced dermatologists, keep costs at a minimum, be user-friendly, and be time efficient with high sensitivity and specificity. Ler mais

Seminars in cutaneous medicine and surgery

Confocal imaging of carbon dioxide laser-ablated basal cell carcinomas: An ex-vivo study on the uptake of contrast agent and ablation parameters.

Feb, 2016

Laser ablation can be an effective treatment for the minimally invasive removal of superficial and early nodular basal cell carcinomas (BCCs). However, the lack of histological confirmation after ablation results in high variability of recurrence rates and has been a limitation. Reflectance confocal microscopy (RCM) imaging, combined with a contrast agent, may detect the presence (or absence) of residual BCC tumors directly on the patient and thus provide noninvasive histology-like feedback to guide ablation. The goal of this ex vivo bench-top study was to determine affective ablation parameters (fluence, number of passes) for a CO2 laser that will allow both removal of BCCs and control of the underlying thermal coagulation zone in post-ablated tissue to enable uptake of contrast agent and RCM imaging. Ler mais

Lasers in surgery and medicine

Assessing Improvement of Facial Appearance and Quality of Life after Minimally-Invasive Cosmetic Dermatology Procedures Using the FACE-Q Scales.

Jan, 2016

Detecting clinically meaningful change from the patients' perspective is critical to evaluating a successful cosmetic procedure. FACE-Q is a patient-reported outcome instrument for use in patients undergoing cosmetic procedures. Ler mais

Journal of drugs in dermatology : JDD

Injectable Cosmetic Procedures for the Male Patient.

Sep, 2015

More than ever, male patients are seeking cosmetic procedures for a variety of reasons including but not limited to: a less aged appearance, social, or work related issues. Injectable neurotoxins and fillers are appealing to the male patient for their safety, rapid results, and minimal downtime. However, methods applied to the female patient do not always translate to the male patient. In this article, we review the anatomical, biological, and behavioral differences in men. We also provide an in-depth discussion of the techniques and dosages that are used in men, emphasizing the distinctions between the sexes. While once overlooked, this gender is becoming an important demographic in cosmetic dermatology. Ler mais

Journal of drugs in dermatology : JDD

Intraoperative real-time reflectance confocal microscopy for guiding surgical margins of lentigo maligna melanoma.

Aug, 2015

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Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

Serum Sirolimus Level Elevation Induced by Acitretin: Report of a Novel Drug-Drug Interaction.

Jul, 2015

Long-term immunosuppression in the organ transplant recipient (OTR) population places these individuals at higher risk of developing skin malignancies. Oral retinoids have become a useful tool for pharmacologic prophylaxis in the OTR population. Immunosuppressants that inhibit mTOR, such as sirolimus, may be used in combination with a systemic retinoid for chemoprophylaxis of cutaneous malignancies. We present the case of a male patient status post second renal transplant who developed an abrupt and unexpected rise in sirolimus levels to supra-therapeutic levels after initiation of prophylactic acitretin for innumerable squamous cell carcinomas (SCC). The sirolimus levels returned to baseline after cessation of acitretin. Systemic drug-drug interactions are an important phenomenon, especially in the solid OTR population. It is postulated that this interaction was mediated by acitretin inhibition of CYP3A4, the primary enzyme responsible for sirolimus metabolism. The Drug Interaction Probability Scale (DIPS) indicates this was a "probable" drug-drug interaction. To date, this interaction has not been reported in the literature. This case accentuates the importance of close monitoring of solid OTRs for adverse medication interactions when multiple medications are taken. Ler mais

Journal of drugs in dermatology : JDD

A case of delayed anaphylaxis after laser tattoo removal.

Mar, 2015

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JAAD case reports

Health-related quality of life in skin cancer patients.

Nov, 2014

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Cutis

Silencing of miR-148a in cancer-associated fibroblasts results in WNT10B-mediated stimulation of tumor cell motility.

Jul, 2013

The tumor microenvironment has an important role in cancer progression. Here we show that miR-148a is downregulated in 15 out of 16 samples (94%) of cancer-associated fibroblasts (CAFs) compared with matched normal tissue fibroblasts (NFs) established from patients with endometrial cancer. Laser-capture microdissection of stromal cells from normal tissue and endometrial cancer confirmed this observation. Treatment of cells with 5-aza-deoxycytidine stimulated the expression of miR-148a in the majority of CAFs implicating DNA methylation in the regulation of miR-148a expression. Investigation of miR-148a function in fibroblasts demonstrated that conditioned media (CM) from CAFs overexpressing miR-148a significantly impaired the migration of five endometrial cancer cell lines without affecting their growth rates in co-culture experiments. Among predicted miR-148a target genes are two WNT family members, WNT1 and WNT10B. Activation of the WNT/β-catenin pathway in CAFs was confirmed by microarray analysis of gene expression and increased activity of the SuperTOPFlash luciferase reporter. We found elevated levels of WNT10B protein in CAFs and its level decreased when miR-148a was re-introduced by lentiviral infection. The 3'-UTR of WNT10B, cloned downstream of luciferase cDNA, suppressed luciferase activity when co-expressed with miR-148a indicating that WNT10B is a direct target of miR-148a. In contrast to the effect of miR-148a, WNT10B stimulated migration of endometrial cancer cell lines. Our findings have defined a molecular mechanism in the tumor microenvironment that is a novel target for cancer therapy. Ler mais

Oncogene

Multiple Adult Xanthogranulomas Associated With Cutaneous Lymphoid Hyperplasia and Lupus Erythematosus.

2016

A 50-year-old woman presented to our clinic for evaluation of numerous recurrent, pruritic papules on her upper extremities. She reported a 2- to 3-year history of up to eight unique lesions on the bilateral upper arms that would initially appear as firm papules before gradually softening and flattening out, leaving residual pink macules (Figure 1A). Her medical history was notable for mild hyperlipidemia. On presentation, she had several erythematous papules with overlying telangiectasias scattered throughout her bilateral upper arms. One lesion of concern over the left deltoid had been present for 5 months without signs of regression (Figure 1B). Pathology of this and a similar lesion showed histiocytes forming Touton giant cells with foamy cytoplasm consistent with a xanthogranuloma (AXG). Results from immunoperoxidase stains were negative for factor XIIIa and CD1a, diffusely positive for CD68, and focally positive for S100 (Figure 2). Ler mais

Skinmed

Radiation therapy for synchronous basal cell carcinoma and lentigo maligna of the nose: Response assessment by clinical examination and reflectance confocal microscopy.

2015

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Practical radiation oncology