Twenty years ago, children with HbSS SCD were expected to have autosplenectomy by age 5 years. There have been changes in the radiologic appearance of the spleen in patients with SDC, likely due to improved supportive care and the use of acute and chronic transfusion therapy. We found that autosplenectomy is rare by age 5 years, and during childhood and adolescence, the spleen typically appears echogenic, heterogeneous, or both, depending on disease severity.

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We analyzed a large, multicenter, retrospective cohort of 368 adult patients with SJS/TEN from the United States. 4 Of 314 patients known to survive to hospital discharge, 150 (47.8%) had information available regarding postdischarge follow-up. Of these, there was no mention of SJS/TEN-related sequelae in 54.7% (82/150), and long-term sequelae were noted in the remaining 45.3% (68/150), characterized as ocular, cutaneous, gastrointestinal, genital, renal, pulmonary, or other. Sequelae were reported to be severe in 15.3% (23/150) of patients (Table I). Ocular sequelae were most common (20.6%, 31/150), followed by cutaneous (19.3%, 29/ 150), genital (5.3%, 8/150), oral (4.0%, 6/150), renal (2.0%, 3/150), and gastrointestinal (0.67%, 1/150). Other sequelae not fitting into these categories included depression, anxiety, chronic pain, tinnitus, and limb amputations.At the time of initial hospitalization, 12.7% (19/ 150) of patients had severe ocular SJS/TEN, and 34.0% (51/150) had severe oral SJS/TEN. Such patients, as well as those with higher median body surface area involvement, were at increased risk of long-term sequelae, including sequelae characterized as severe (all P \ .01). Patients with severe genitourinary SJS/TEN (12.7%, 19/150) were also at risk of severe long-term sequelae (P ¼ .02) (Table I).There was no association between age, sex, or race and the risk of long-term sequelae in this cohort. SJS/TEN cause/trigger and days from symptom onset to hospital admission, dermatology consultation, diagnosis, and drug discontinuation also were not associated with development of SJS/TEN-related sequelae.These data suggest that long-term SJS/TEN-related sequelae are relatively common and frequently severe, corroborating rates of previously reported sequelae in SJS/TEN. Higher acuity of SJS/TEN at the time of initial presentation-specifically, the presence of severe mucosal disease and higher total body surface area involvement-predicts the development of long-term SJS/TEN-related sequelae.This study is limited by its retrospective nature, which obscures a detailed accounting of the specific features of patient sequelae and almost certainly underestimates their prevalence, because information on sequelae was determined via retrospective chart review rather than prospective systematic evaluation and was not available for all patients. Because all patients were managed by dermatology hospitalists at academic referral centers, results may not be fully generalizable. Future studies should prospectively evaluate the longterm sequelae of patients with SJS/TEN as an important marker of disease outcome and treatment efficacy. Clinicians should be aware of the potential for long-term complications among SJS/TEN survivors.

Many previous reviews and studies on transgender dermatology have highlighted the expected dermatologic manifestations of hormone affirmation therapy in transgender patients. Others have highlighted attitudes and practices of both transgender patients and medical professionals taking care of these patients. This review compiles data from other, lesser known aspects of transgender dermatology, including neovaginal concerns, neoplastic concerns (both neovaginal and cutaneous), autoimmune conditions, and the sequelae of injectable substances that have not been approved by the U.S. Food and Drug Administration. This review, like others, will be a stepping-stone and serve as an impetus for future research in transgender dermatology.