ABSTRACT: Introduction: Cutaneous marginal zone lymphoma (CMZL) and cutaneous follicle center lymphoma (CFCL) are rare indolent cutaneous B-cell lymphomas (CBCL). Their incidence in African American (AA) patients is extremely low. While cutaneous T-cell lymphomas appear to be more aggressive in AA individuals, there is no data on the presentation and course of disease of CBCL in this group. In this study, we aimed to characterize CMZL/CFCL in AA patients.
Methods: A retrospective chart review identified 10 AA patients with CMZL/CFCL. We compared demographics, clinical features, and systemic disease incidence between AA and white patients.
Results: Of 288 patients with CMZL/CFCL, 10 patients were AA (3.5%), and 266 were white. AA patients trended toward diagnosis at a younger age compared to white individuals (median age of 41 vs 54 years; P=0.07). AAs presented with more regional and generalized cutaneous disease (T2-T3 in 70%), while most white patients presented with a solitary lesion (T1 in 55%). Head and neck involvement was more common in AA patients. Extracutaneous systemic disease at initial staging was not significantly different between the groups. One AA patient with primary CMZL developed extracutaneous MZL after16 years. No deaths were reported among AAs.
Discussion: CMZL/ CFCL in this series of AA patients had an earlier age of onset with preferential head and neck involvement and a higher T classification at presentation. Despite these features, systemic involvement was uncommon, and no deaths were recorded. This data supports an indolent course of CMZL and CFCL in the AA population; larger studies are needed to confirm these findings.
J Drugs Dermatol. 2018;17(12):1334-1337. more
ABSTRACT: Rituximab is a chimeric anti-CD20 monoclonal antibody that is very effective in treating patients with pemphigus vulgaris. Though infrequent, the development of human anti-chimeric antibodies in patients receiving rituximab results in loss of efficacy. Ofatumumab is a second-generation fully-human anti-CD20 monoclonal antibody currently used to treat chronic lymphocytic leukemia. We report a case of a patient with pemphigus vulgaris successfully treated with ofatumumab after developing human anti-chimeric antibodies to rituximab.
J Drugs Dermatol. 2018;17(12):1338-1339. more
ABSTRACT: The U.S. Census Bureau defines the Millennial generation as those born between 1982 and 2000, placing the upper age range at 36 years old. The largest generation in US history, outnumbering Baby Boomers and representing more than one-quarter of the US population, they are poised to reshape the economy. They are outspending Baby Boomers 2 to 1 on self-care, and the ASDS 2016 annual survey reported that, in the prior year, patients under 30 saw 20% growth in neuromodulators and 100% growth in injectable filler procedures. As such, they represent a significant segment of the dermatology patient base and understanding how best to communicate with the individuals who comprise this singular collective is key to delivering the best quality and experience of care in a medical or aesthetic practice. A search of PubMed.gov yields no studies relating to the behaviors of millennial patients, and since many of the understandings of the millennial mindset have been developed in the finance, tech, retail, and wellness arenas, we can draw on these insights to enhance connection with the next generation of patients.
J Drugs Dermatol. 2018;17(12):1340-1342. more