The most common bacteria isolated from wound cultures in patients recorded in the Epidermolysis Bullosa Clinical Characterization and Outcomes Database (EBCCOD) are Staphylococcus aureus and Pseudomonas aeruginosa. Given the prevalence of P. aeruginosa in this patient population and prior research implicating P. aeruginosa's potential role in carcinogenesis, we sought to further analyze patients with recorded wound cultures positive for Pseudomonas aeruginosa in the EBCCOD. We provide a descriptive analysis of this subset of patients and highlight potential avenues for future longitudinal studies that may have significant implications in our wound care management for patients with epidermolysis bullosa.
Pigmented epithelioid melanocytoma (PEM) is an intermediate-grade melanocytic tumor with considerable histologic overlap with other melanocytic neoplasms such as epithelioid blue nevus (EBN), which is associated with the neoplastic syndrome Carney complex (CC). Nextgeneration sequencing is a valuable tool for identifying the primary drivers of melanocytic neoplasms and differentiating them from one another. While germline variants in the protein kinase cAMP-dependent regulatory type 1 alpha (PRKAR1A) gene have been associated with EBN and CC, fusions in protein kinase C-alpha (PRKCA) have been shown as sporadic drivers of PEM. Herein, we report the diagnosis and workup of a case of pigmented epithelioid melanocytoma with a novel protein kinase Cbeta (PRKCB) fusion.
Regular moisturizing with over‐the‐counter (OTC) treatments is considered a cornerstone of atopic dermatitis (AD) management regardless of disease severity, but OTC moisturizers are not an eligible product under most state Medicaid benefits, including those of New York (NY). Removing the financial barrier to AD management may lessen both the economic burden and emotional toll of the disease for patients and their families with the added benefit of decreasing healthcare costs. Herein, the theoretical annual cost of OTC moisturizer was calculated for a patient with AD in NY to range between $35.13 to $63.35 for infants to $175.66 to $316.75 for adults, and Medicaid reimbursement rates and reported direct and indirect costs of AD were reviewed. We conclude with a discussion of Medicaid coverage criteria for drugs, cost‐effectiveness and preventative medicine, and the role of advocacy for changes in health policy.
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