Browsing by Author "Streicher, Jenna L."

Now showing 1 - 5 of 5
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    Benzene in Benzoyl Peroxide – How Worried Should We Be?
    (Elsevier, 2024-10) Barbieri, John S.; Streicher, Jenna L.; Rosmarin, David; Dermatology, School of Medicine
    Benzoyl peroxide (BPO) is a foundational acne treatment that can also prevents the development of Cutibacterium acnes resistance to antibiotics.1 However, BPO has the potential to thermally decompose into benzene, a known carcinogen.2 Two recent reports released by the independent laboratory Valisure have suggested that common BPO products may contain concerning levels of benzene after incubation for days to weeks at temperatures of 37°C (99°F) and 50°C (122°F).2,3 In addition, these reports describe that some products had detectible levels of benzene when procured, but do not provide specific details beyond summary level data regarding the number of products with >2 (19/66) or >10 ppm (10/66) of benzene detected.3
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    Clinical Features, Prognostic Factors, and Treatment Interventions for Ulceration in Patients With Infantile Hemangioma
    (American Medical Association, 2021) Faith, Esteban Fernández; Shah, Sonal; Witman, Patricia M.; Harfmann, Katya; Bradley, Flora; Blei, Francine; Pope, Elena; Alsumait, Anwar; Gupta, Deepti; Covelli, Isabela; Streicher, Jenna L.; Cotton, Colleen; Tollefson, Megha; Nguyen, Henry; Hunt, Raegan; Moore-Clingenpeel, Melissa; Frieden, Ilona J.; Dermatology, School of Medicine
    Importance: Ulceration is a common complication of infantile hemangioma (IH), which leads to substantial morbidity. Ulceration in IH has not been systematically studied since the advent of β-blocker therapy for IH. Objectives: To examine treatment interventions used for ulceration in IH and identify clinical prognostic indicators of healing time. Design, setting, and participants: A retrospective, multicenter cohort study was conducted on 436 consecutive patients with a clinical diagnosis of ulcerated IH and available clinical photographs. Patients receiving care at tertiary referral centers evaluated between 2012 and 2016 were included; statistical and data analysis were performed from February 7 to April 27, 2020. Exposures: Clinical characteristics, treatment interventions, course, complications, and resource use were analyzed. Treatment interventions for ulceration in IH included local (wound care, topical), systemic (β-blocker, corticosteroids), and procedural (pulsed-dye laser). Main outcomes and measures: The primary end point was time to complete or nearly complete ulceration healing. Clinical characteristics were analyzed to determine the responses to most common interventions and prognostic factors for healing of ulceration. Results: Of the 436 patients included in the study, 327 were girls (75.0%); median age at ulceration was 13.7 weeks (interquartile range, 8.86-21.30 weeks). The median heal time was 4.79 weeks (95% CI, 3.71-5.86 weeks) with wound care alone, 5.14 weeks (95% CI, 4.57-6.00 weeks) with timolol, 6.36 weeks (95% CI, 5.57-8.00 weeks) with a systemic β-blocker, and 7.71 weeks (95% CI, 6.71-10.14 weeks) with multimodal therapy. After adjusting for IH size, a dose of propranolol less than or equal to 1 mg/kg/d was associated with shorter healing time compared with higher propranolol doses (hazard ratio, 2.04; 95% CI, 1.11 to 3.73; P = .02). Size of the IH was identified as a significant prognostic factor for healing time in multivariable analysis. Increasing size of IH portends a proportionately longer time to heal of the ulceration. Conclusions and relevance: Despite the use of β-blockers, this cohort study found that a subset of patients with IH ulceration continued to experience prolonged IH healing times. Larger IH size appears to be a poor prognostic factor for time to heal. For patients requiring systemic therapy, initiation of propranolol at lower doses (≤1 mg/kg/d) should be considered.
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    Comfort positioning during procedures in pediatric dermatology
    (Wiley, 2020-03) Skaljic, Meliha; McGinnis, Andrea; Streicher, Jenna L.; Pediatrics, School of Medicine
    Procedures performed in pediatric dermatology can often be painful or distressing for patients and their families. Comfort positioning, which involves sitting the child upright, immobilized and held by a caretaker, is one strategy that may be employed in this setting; this measure has been shown to reduce patient distress, improve cooperation and give caretakers a more active role in the procedure. We demonstrate several positions of comfort for dermatologic procedures involving the arm, cheek, back and leg of a young child.
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    Vaccine considerations for adult dermatology patients on immunosuppressive and immunomodulatory therapies: a clinical review
    (University of California, 2021-09-09) Tan, Alice J.; Streicher, Jenna L.; Merola, Joseph F.; Noe, Megan H.; Dermatology, School of Medicine
    Adults with chronic inflammatory skin disease are at increased risk of vaccine-preventable illnesses and infections, likely because of the underlying disease itself and also their treatment with immunosuppressive and immunomodulatory medications. Despite the association between these agents and increased susceptibility to infection, vaccination rates in dermatology patients remain low. Although preventative care such as vaccinations is typically managed by primary care providers, dermatologists serve a critical role in spreading awareness of the specific risks of immunosuppressive and immunomodulatory agents and promoting understanding of individualized vaccine recommendations. In this review, we provide evidence-based information on vaccine recommendations for adult dermatology patients, specific to age and medication use.
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    Vaccines: Considerations for pediatric dermatology patients on immunosuppressive agents
    (Wiley, 2021) Munshi, Mumtaz A.; Noe, Megan H.; Chiu, Yvonne E.; Streicher, Jenna L.; Dermatology, School of Medicine
    Pediatric dermatologists should be aware of immunization schedules and special recommendations for patients on immunosuppressive agents due to the increased risk of vaccine-preventable infections. Prior to initiating immunosuppressive therapy, pediatric dermatologists should review a vaccine history and administer any necessary age-appropriate or catch-up vaccines. Live vaccines are typically contraindicated while on immunosuppressive therapy, while inactivated vaccines are generally safe to administer.