Uma N. Sundram, MD, PhD

Clinical Focus

• Pathology
• Anatomic/Clinical Pathology

Professional Education

Web Site Links

• Department of Pathology

Research Interests

My research program is primarily centered on the exploration of mechanisms driving hematopoietic disorders in the skin. Compared to hematopoietic disorders (lymphomas, leukemias, and mast cell disease) that involve other organs in the body, such as the lymph node, bone marrow, and spleen, the counterparts of these diseases in the skin have a different clinical presentation, course, and outcome. For example, patients with the most common lymphoma that starts in the skin, mycosis fungoides, can have a long and fruitful life, if the disease is limited to the skin and does not involve other organs in the body. For this reason, clinicians usually treat these patients with more conservative therapies (such as topical steroids) to control the disease, rather than with systemic chemotherapy, as in the case of their systemic counterparts. The most common type of mast cell disease of the skin, urticaria pigmentosa, occurs frequently in children, and can regress before puberty. On the other hand, adult patients with mast cell disease that involve organs other than skin can have a more aggressive clinical course, with a subset of these patients dying from their disease. Although the characteristics of the genes and proteins that cause these diseases are currently being studied, a key discovery would lie in our ability to distinguish patients who are going to do well (because their disease will be limited to the skin) from patients who may not do as well. The importance of this distinction would be in the therapeutic approach: patients with more aggressive disease would get more aggressive therapy. Unfortunately, cutaneous lymphomas are notoriously difficult to diagnose accurately, as they can look very much like reactive processes under the microscope. Similarly, although it is relatively straightforward to render the diagnosis of mast cell disease in the skin, distinguishing mast cell disease that will spontaneously regress from those that will have a more aggressive clinical course...

Publications

• Low stage follicular lymphoma: biologic and clinical characterization according to nodal or extranodal primary origin. Weinberg OK, Ma L, Seo K, Beck AH, Pai RK, Morales A, Kim Y, Sundram U, Tan D, Horning SJ, Hoppe RT, Natkunam Y, Arber DA. Am J Surg Pathol. 2009; 33 (4): 591-8
• A malignant cutaneous neuroendocrine tumor with features of Merkel cell carcinoma and differentiating neuroblastoma. Vanchinathan V, Marinelli EC, Kartha RV, Uzieblo A, Ranchod M, Sundram UN. Am J Dermatopathol. 2009; 31 (2): 193-6
• Cutaneous peripheral T-cell lymphoma associated with a proliferation of B cells. Mattoch IW, Fulton R, Kim Y, Hoppe R, Warnke RA, Sundram UN. Am J Clin Pathol. 2009; 131 (6): 810-9
• Review: Dermatofibrosarcoma protuberans: histologic approach and updated treatment recommendations. Sundram UN, Clin Adv Hematol Oncol. 2009; 7 (6): 406-8
• Persistent scale in the diaper area. Bedocs LA, Mattoch I, Sundram U, Bruckner AL. Pediatr Dermatol. 2008 Jul-Aug; 25 (4): 477-8