#dermJC Transcript
Healthcare social media transcript of the #dermJC hashtag.
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| Profile | Tweet |
|---|---|
 | Roxana Daneshjou MD/PhD @RoxanaDaneshjou Hi, I’m Roxana. Derm resident @StanfordMed. Disclosure: consult for enspectra health. #dermjc |
 | Joel Sunshine @joelsunshine Hi. I'm Joel. PGY-4 dermatology resident at @NorthwesternMed. No COI. #dermjc |
 | Dermatology Journal Club @DermatologyJC Here is the link to the open access paper (made so especially for #dermjc) again. Many thanks to @JAMADerm https://t.co/9yDzw8vuCh |
 | Dr. Carolyn Lee, MD/PhD @CarolynLeeMDPhD Hi, Cari Lee from @StanfordMed derm. No COI. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou This paper is short but I was hoping it would spur a larger discussion about cutaneous SCCs in the immunosuppressed population. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @joelsunshine: Hi. I'm Joel. PGY-4 dermatology resident at @NorthwesternMed. No COI. #dermjc |
| Joel Sunshine @joelsunshine Overall, this study adds to the body of literature which demonstrates that immunosuppressed patients are at significantly higher risk to develop multiple SCCs, and have higher risk of recurrent disease. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @CarolynLeeMDPhD: Hi, Cari Lee from @StanfordMed derm. No COI. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: Hi, I’m Roxana. Derm resident @StanfordMed. Disclosure: Hi, I’m Roxana. Derm resident @StanfordMed. Disclosure: consult for enspectra health. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: This paper is short but I was hoping it would spur a larger discussion about cutaneous SCCs in the immunosuppressed population. #dermjc |
 | Steven Chen 陳持威, MD, MPH, MHPEd @DrStevenTChen Hi #dermjc! Steven from Boston. No COI. |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @AshleyLundgren4 Welcome to #dermtwitter #dermjc! https://t.co/jWsRQa7xDG |
| Dermatology Journal Club @DermatologyJC RT @joelsunshine: Overall, this study adds to the body of literature which demonstrates that immunosuppressed patients are at significantly higher risk to develop multiple SCCs, and have higher risk of recurrent disease. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrStevenTChen: Hi #dermjc! Steven from Boston. No COI. |
| Joel Sunshine @joelsunshine I would have liked to see the data broken down more clearly by type and duration of immunosuppression, how tumors were treated, and whether they were on any other treatment to reduce recurrence risk, but small sample size may have limited the ability to break it down more #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @joelsunshine Yes me too - and I believe certain organ transplant patients are higher risk than others. @CarolynLeeMDPhD probably knows this data. #dermjc |
 | David Harker, MD, FAAD @HarkerDavid @DermatologyJC David Harker. Derm resident at UTSW. Currently distracted by playoff hockey. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou RT @joelsunshine: I would have liked to see the data broken down more clearly by type and duration of immunosuppression, how tumors were treated, and whether they were on any other treatment to reduce recurrence risk, but small sample size may have limited the ability to break it down more #dermjc |
| Dermatology Journal Club @DermatologyJC RT @HarkerDavid: @DermatologyJC David Harker. Derm resident at UTSW. Currently distracted by playoff hockey. #dermjc |
| Joel Sunshine @joelsunshine @RoxanaDaneshjou @CarolynLeeMDPhD Duration and intensity of immunosuppression are important. My impression is that certain organs typically need more immunosuppression to maintain the graft, but that the risk differences are mostly due to increased immunosuppression itself #dermjc |
| Dermatology Journal Club @DermatologyJC RT @joelsunshine: @RoxanaDaneshjou @CarolynLeeMDPhD Duration and intensity of immunosuppression are important. My impression is that certain organs typically need more immunosuppression to maintain the graft, but that the risk differences are mostly due to increased immunosuppression itself #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou Btw this is a paper I think of often, that highlights the importance of a FULL body skin exam in immunosuppressed patients. #dermjc https://t.co/f5IbeT78tw https://t.co/LiaNkXrdGF |
| Dr. Carolyn Lee, MD/PhD @CarolynLeeMDPhD @RoxanaDaneshjou @joelsunshine In general, lung and heart transplant recipients are at higher risk than others. That being said, I have had a few older renal transplant recipients with multiple synchronous SCC or multiply-recurrent SCC, usually in the setting of high doses of IS medications. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: Btw this is a paper I think of often, that highlights the importance of a FULL body skin exam in immunosuppressed patients. #dermjc https://t.co/f5IbeT78tw https://t.co/LiaNkXrdGF |
| Dermatology Journal Club @DermatologyJC RT @CarolynLeeMDPhD: @RoxanaDaneshjou @joelsunshine In general, lung and heart transplant recipients are at higher risk than others. That being said, I have had a few older renal transplant recipients with multiple synchronous SCC or multiply-recurrent SCC, usually in the setting of high doses of IS medications. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou So I am curious how often you guys all screen your transplant patients for skin cancer. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @ealtmanmd - join us in #dermjc! |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou I am on my surgical rotation right now and being reminded by how aggressive SCC in the immunosuppressed can act.#dermjc |
| Steven Chen 陳持威, MD, MPH, MHPEd @DrStevenTChen @CarolynLeeMDPhD @RoxanaDaneshjou @joelsunshine The burden seen in renal transplant always feels so high, but I think that's probably just by virtue of there being so many more renal transplant patients by absolute numbers! #dermjc |
| Steven Chen 陳持威, MD, MPH, MHPEd @DrStevenTChen @RoxanaDaneshjou Well, I don't run our transplant clinic, but from what I remember from residency, they are all referred to derm as part of the post transplant care. Then they get yearly checks until first skin cancer, then its q6mo as per usual, but perhaps less likely to space back out. #dermjc |
 | Ashley Lundgren MD @AshleyLundgren4 It varies for us but at minimum yearly even if no history of skin cancer. Can be as frequent as every three months depending on patient, burden of skin disease, prevention strategies (PDT, topicals), etc #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou Also recall that patients with CLL are also immunosuppressed and have higher skin cancer rates but this group wasn’t addressed in the paper. #dermjc https://t.co/gLiZi06HB1 |
| Dermatology Journal Club @DermatologyJC RT @AshleyLundgren4: It varies for us but at minimum yearly even if no history of skin cancer. Can be as frequent as every three months depending on patient, burden of skin disease, prevention strategies (PDT, topicals), etc #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrStevenTChen: @RoxanaDaneshjou Well, I don't run our transplant clinic, but from what I remember from residency, they are all referred to derm as part of the post transplant care. Then they get yearly checks until first skin cancer, then its q6mo as per usual, but perhaps less likely to space back out. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: I am on my surgical rotation right now and being reminded by how aggressive SCC in the immunosuppressed can act.#dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: Also recall that patients with CLL are also immunosuppressed and have higher skin cancer rates but this group wasn’t addressed in the paper. #dermjc https://t.co/gLiZi06HB1 |
| David Harker, MD, FAAD @HarkerDavid RT @RoxanaDaneshjou: Btw this is a paper I think of often, that highlights the importance of a FULL body skin exam in immunosuppressed patients. #dermjc https://t.co/f5IbeT78tw https://t.co/LiaNkXrdGF |
| Dr. Carolyn Lee, MD/PhD @CarolynLeeMDPhD Chronic prednisone alone (especially when other risk factors are present) can also increase the risk of developing NMSC: https://t.co/T0pjxlRrTR #dermjc |
| Dermatology Journal Club @DermatologyJC RT @CarolynLeeMDPhD: Chronic prednisone alone (especially when other risk factors are present) can also increase the risk of developing NMSC: https://t.co/T0pjxlRrTR #dermjc |
 | David Fudman, MD @fudmanMD Full body skin exams so important for #IBD patients, especially for those on medications that affect the immune system! |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou And there is this other @JAMADerm paper talking about the features that make for aggressive SCC in transplant patients. The outcomes can be very poor in the immunosuppressed. #dermjc https://t.co/Jv5VoowcUc https://t.co/oiNgKd9Q1X |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: And there is this other @JAMADerm paper talking about the features that make for aggressive SCC in transplant patients. The outcomes can be very poor in the immunosuppressed. #dermjc https://t.co/Jv5VoowcUc https://t.co/oiNgKd9Q1X |
 | John Barbieri, MD, MBA @DrJohnBarbieri Hi everyone, sorry I’m late, had to finish watching @celtics pull out the win! No COI #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou 5 year disease specific survival of 30 percent! As one attending put it, “it’s a tragedy to receive the gift of life but then die from skin cancer from the immunosuppressive”. #dermjc |
| Dr. Carolyn Lee, MD/PhD @CarolynLeeMDPhD @DrStevenTChen @RoxanaDaneshjou @joelsunshine This could very well be the case. I've also wondered whether immunosuppressive regimens have changed over time as every once in a while I see an older renal transplant patient on what seems like an enormous dose of azathioprine - perhaps #nephjc can answer this for us! #dermjc |
 | Emily M. Altman, MD @ealtmanmd @CarolynLeeMDPhD @RoxanaDaneshjou @joelsunshine Even more so in transplant patients that had extensive sun exposure and sun damage prior to immunosuppression. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @CarolynLeeMDPhD: @DrStevenTChen @RoxanaDaneshjou @joelsunshine This could very well be the case. I've also wondered whether immunosuppressive regimens have changed over time as every once in a while I see an older renal transplant patient on what seems like an enormous dose of azathioprine - perhaps #nephjc can answer this for us! #dermjc |
| Dermatology Journal Club @DermatologyJC RT @ealtmanmd: @CarolynLeeMDPhD @RoxanaDaneshjou @joelsunshine Even more so in transplant patients that had extensive sun exposure and sun damage prior to immunosuppression. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: Hi everyone, sorry I’m late, had to finish watching @celtics pull out the win! No COI #dermjc |
| Joel Sunshine @joelsunshine @ealtmanmd @CarolynLeeMDPhD @RoxanaDaneshjou This paper showed that background actinic field damage is pretty predictive of SCC development in renal transplant patients (in a small cohort); important to keep a close eye on those patients https://t.co/BuBQFkB7yQ #dermjc |
| Emily M. Altman, MD @ealtmanmd @RoxanaDaneshjou Every three to six months if previous SCC depending on how recent and how deep. My heart transplant folks wanted CTs for any invasive SCC in their patients. Unreal how ugly SCC can be #dermjc |
| Dr. Carolyn Lee, MD/PhD @CarolynLeeMDPhD @RoxanaDaneshjou There appears to be a high rate of BCC recurrence in CLL patients. I mention it for our derm residents because it was a question on my boards. #dermjc https://t.co/GGVFLrqTTR |
| Joel Sunshine @joelsunshine @CarolynLeeMDPhD @RoxanaDaneshjou Is this due to their being immunosuppressed alone, or also because the extra inflammation in the MOHS specimen makes it hard to establish good margins? #dermJC |
| John Barbieri, MD, MBA @DrJohnBarbieri RT @joelsunshine: @ealtmanmd @CarolynLeeMDPhD @RoxanaDaneshjou This paper showed that background actinic field damage is pretty predictive of SCC development in renal transplant patients (in a small cohort); important to keep a close eye on those patients https://t.co/BuBQFkB7yQ #dermjc |
| Dr. Carolyn Lee, MD/PhD @CarolynLeeMDPhD @joelsunshine @ealtmanmd @RoxanaDaneshjou And consider field treatment for those high risk patients! #dermjc |
| Dermatology Journal Club @DermatologyJC RT @ealtmanmd: @RoxanaDaneshjou Every three to six months if previous SCC depending on how recent and how deep. My heart transplant folks wanted CTs for any invasive SCC in their patients. Unreal how ugly SCC can be #dermjc |
| Dermatology Journal Club @DermatologyJC RT @joelsunshine: @ealtmanmd @CarolynLeeMDPhD @RoxanaDaneshjou This paper showed that background actinic field damage is pretty predictive of SCC development in renal transplant patients (in a small cohort); important to keep a close eye on those patients https://t.co/BuBQFkB7yQ #dermjc |
| Dermatology Journal Club @DermatologyJC RT @CarolynLeeMDPhD: @RoxanaDaneshjou There appears to be a high rate of BCC recurrence in CLL patients. I mention it for our derm residents because it was a question on my boards. #dermjc https://t.co/GGVFLrqTTR |
| Dermatology Journal Club @DermatologyJC RT @joelsunshine: @CarolynLeeMDPhD @RoxanaDaneshjou Is this due to their being immunosuppressed alone, or also because the extra inflammation in the MOHS specimen makes it hard to establish good margins? #dermJC |
| John Barbieri, MD, MBA @DrJohnBarbieri @joelsunshine @ealtmanmd @CarolynLeeMDPhD @RoxanaDaneshjou Sometimes I wonder if we should try to better subcategorize AKs. It feels like there may be multiple phenotypic patterns with different risk for subsequent keratinocytic skin cancer (as supported by the above study). #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: @joelsunshine @ealtmanmd @CarolynLeeMDPhD @RoxanaDaneshjou Sometimes I wonder if we should try to better subcategorize AKs. It feels like there may be multiple phenotypic patterns with different risk for subsequent keratinocytic skin cancer (as supported by the above study). #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DrJohnBarbieri @joelsunshine @ealtmanmd @CarolynLeeMDPhD I often wonder this too. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou RT @CarolynLeeMDPhD: @joelsunshine @ealtmanmd @RoxanaDaneshjou And consider field treatment for those high risk patients! #dermjc |
| Joel Sunshine @joelsunshine @DrJohnBarbieri @ealtmanmd @CarolynLeeMDPhD @RoxanaDaneshjou Agreed! And it may be less about the specific AK itself, but the degree of sun damage in the surrounding skin, that is really important #dermjc |
| Dr. Carolyn Lee, MD/PhD @CarolynLeeMDPhD @joelsunshine @RoxanaDaneshjou Great question - my sense is that it is likely a little bit of both as transplant recipients are at slightly higher risk of developing BCC. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou I feel like this paper reminded me to keep my index of suspicion high in immunosuppressed patients, as the results of delayed SCC diagnosis can be catastrophic in this population. #dermjc |
| Dr. Carolyn Lee, MD/PhD @CarolynLeeMDPhD @joelsunshine @DrJohnBarbieri @ealtmanmd @RoxanaDaneshjou In fact, somatic mutations in important tumor suppressor genes are present in clinically normal, sun-exposed skin. #dermjc https://t.co/ph4gnHNHnn |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: I feel like this paper reminded me to keep my index of suspicion high in immunosuppressed patients, as the results of delayed SCC diagnosis can be catastrophic in this population. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @CarolynLeeMDPhD: @joelsunshine @DrJohnBarbieri @ealtmanmd @RoxanaDaneshjou In fact, somatic mutations in important tumor suppressor genes are present in clinically normal, sun-exposed skin. #dermjc https://t.co/ph4gnHNHnn |
| John Barbieri, MD, MBA @DrJohnBarbieri RT @RoxanaDaneshjou: I feel like this paper reminded me to keep my index of suspicion high in immunosuppressed patients, as the results of delayed SCC diagnosis can be catastrophic in this population. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @PriteshSKaria @CarolynLeeMDPhD @DrStevenTChen @joelsunshine We actually discussed this in a joint #dermjc #nephjc! |
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