Bio

Clinical Focus


  • Pediatric Dermatology
  • Ethical Issues in Pediatric Dermatology

Academic Appointments


Administrative Appointments


  • Chair Department of Dermatology, Stanford University School of Medicine - Dermatology (1995 - 2010)

Honors & Awards


  • Franklin G. Ebaugh Jr. Award for Advising Medical Students, Stanford School of Medicine (June 12, 2005)
  • The Best Doctors in America, Naifeh, S., Smith, G.W. Woodward/White (1992-)
  • Assoc Award: Outstanding scientific knowledge, sound clinical judgment & excellent human relations, Children's Hospital of Los Angeles (1976)
  • Department of Pediatrics Award for Outstanding in Study and Care of Children, The Ohio State University (1973)

Professional Education


  • Residency:Children's Hospital Los Angeles (1976) CA
  • Internship:Children's Hospital Los Angeles (1974) CA
  • Board Certification: Dermatology, American Board of Dermatology (1982)
  • Residency:University of Colorado Health Science Center (1982) CO
  • Board Certification: Pediatrics, American Board of Pediatrics (1978)
  • Medical Education:Ohio State University Hospitals (1973) OH
  • Bachelor of Science, University of Dayton, Pre-Medicine (1969)
  • Doctor of Medicine, The Ohio State University, Medicine (1973)
  • Master of Arts, Santa Clara University, Spirituality (2004)

Research & Scholarship

Current Research and Scholarly Interests


Developing gene therapy for genetic skin diseases in children is a major focus of the Department of Dermatology. Specifically our efforts are on correcting the cutaneous basement membrane zone defects in epidermolysis bullosa. This requires coordination of the basic research and clinical care. Prior to developing gene therapy, we are creating better methods to give effective and efficient care to infants and children with rare and disabling genetic skin diseases including epidermolysis bullosa and ichthyosis. We are focused on giving comprehensive skin care in an environment that is supportive for the individual families as well as the communities of families with similar diseases. Additional programs are being developed for infants and children with unusual and difficult to manage vascular malformations by coordinating teams of specialist who are focused on developing better methods to care for infants and children with these conditions.

I am also interested in clinical studies within the Neonatal Intensive Care Unit which include methods to understand the physiology and function of premature infant skin which is extremely fragile, easily injured and traumatized. We are interested in the ability of topical applications of products to protect and heal the premature infant’s skin.

Ambulatory clinical studies include efforts to improve care of infants and children with atopic dermatitis. Clinical trials in other childhood skin diseases are also done.

Clinical Trials


  • Characteristics of Adult Patients With Recessive Dystrophic Epidermolysis Bullosa Not Recruiting

    Recessive dystrophic epidermolysis bullosa (RDEB) is a severe inherited blistering disease caused by the absence of type VII collagen. Patients with RDEB develop large, severely painful blisters and open wounds from minor trauma to their skin. We are screening RDEB subjects to determine additional characteristics of patients who survive to adulthood.

    Stanford is currently not accepting patients for this trial. For more information, please contact Emily Gorell, MS, 650-721-7166.

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  • Characteristics of Patients With Dystrophic Epidermolysis Bullosa Recruiting

    Dystrophic epidermolysis bullosa (DEB) is a group of diseases caused by genetic mutations in the gene for type VII collagen. DEB can be severe or mild with the recessive disease usually being more severe. Patients with DEB develop large, severely painful blisters and open wounds from minor trauma to their skin. We are screening subjects with DEB to evaluate characteristics of the subjects and their cells in order to develop new strategies of therapy.

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  • Sildenafil for the Treatment of Lymphatic Malformations Recruiting

    A Phase 2 study to evaluate safety and efficacy of sildenafil taken orally to improve or resolve lymphatic malformations in children. Subjects may receive either placebo or treatment in an oral dosage with an open label extension for subjects who received placebo. The study treatment assignment will be randomized in a double blind fashion. MRI examination will evaluate change in lesion volume due to treatment. Other safety and efficacy measures will be taken through the 32-week study duration.

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  • A Study to Evaluate Sildenafil for the Treatment of Lymphatic Malformations Not Recruiting

    There is an unsatisfied medical need for a first-line treatment of lymphatic malformations with a good benefit/risk profile. Based on a patient experience in the institution, the investigators plan to verify whether or not the medication sildenafil has a beneficial effect on lymphatic malformations. The investigators plan to do this by treating patients with lymphatic malformations with the medication sildenafil for a 20 week period. This is an investigator initiated study funded by an Innovations in Patient Care grant and a SPARK grant.

    Stanford is currently not accepting patients for this trial. For more information, please contact Andrea Tichy, Ph.D., 650-724-1982.

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  • Gene Transfer for Recessive Dystrophic Epidermolysis Bullosa Recruiting

    Recessive dystrophic epidermolysis bullosa (RDEB) is a severe inherited blistering skin disease caused by absence of a protein known as type VII collagen. Patients with RDEB develop large, severely painful blisters and open wounds from minor trauma to their skin. This trial will create a graft, which the investigators call "LEAES," of the patient's own skin that has been genetically engineered in the investigators lab to express this missing protein. The purpose of this study is to achieve proof-of-concept for this general approach to cell-based gene therapy in humans and to set the stage for further therapeutic extension in RDEB. The investigators will basically take a subject's own cells, correct them in culture, and then transplant the corrected cells back onto them.

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Teaching

2014-15 Courses


Postdoctoral Advisees


Graduate and Fellowship Programs


Publications

Journal Articles


  • Prevalence and characterization of pruritus in epidermolysis bullosa. Pediatric dermatology Danial, C., Adeduntan, R., Gorell, E. S., Lucky, A. W., Paller, A. S., Bruckner, A., Pope, E., Morel, K. D., Levy, M. L., Li, S., Gilmore, E. S., Lane, A. T. 2015; 32 (1): 53-59

    Abstract

    Qualitative data suggest that pruritus is a burdensome symptom in patients with epidermolysis bullosa (EB), but the prevalence of pruritus in children and adults with EB and factors that contribute to pruritus are unknown. The objective of the current study was to quantitatively identify and to characterize pruritus that EB patients experience using a comprehensive online questionnaire. A questionnaire was developed to evaluate pruritus in all ages and all types of EB. Questions that characterize pruritus were included and factors that aggravate symptoms were investigated. Patients from seven North American EB centers were invited to participate. One hundred forty-six of 216 questionnaires were completed (response rate 68%; 73 male, 73 female; median age 20.0 years). Using a 5-point Likert scale (1 = never, 2 = rarely, 3 = sometimes, 4 = often, 5 = always), itchiness was the most bothersome EB complication (mean 3.3). The average daily frequency of pruritus increased with self-reported EB severity. Pruritus was most frequent at bedtime (mean 3.8) and interfered with sleep. Factors that aggravated pruritus included healing wounds, dry skin, infected wounds, stress, heat, dryness, and humidity. Pruritus is common in individuals with EB and can be bothersome. Future studies will need to investigate the most effective treatments given to individuals with EB for pruritus.

    View details for DOI 10.1111/pde.12391

    View details for PubMedID 25236506

  • Human COL7A1-corrected induced pluripotent stem cells for the treatment of recessive dystrophic epidermolysis bullosa SCIENCE TRANSLATIONAL MEDICINE Sebastiano, V., Zhen, H. H., Derafshi, B. H., Bashkirova, E., Melo, S. P., Wang, P., Leung, T. L., Siprashvili, Z., Tichy, A., Li, J., Ameen, M., Hawkins, J., Lee, S., Li, L., Schwertschkow, A., Bauer, G., Lisowski, L., Kay, M. A., Kim, S. K., Lane, A. T., Wernig, M., Oro, A. E. 2014; 6 (264)
  • Human COL7A1-corrected induced pluripotent stem cells for the treatment of recessive dystrophic epidermolysis bullosa. Science translational medicine Sebastiano, V., Zhen, H. H., Haddad, B., Bashkirova, E., Melo, S. P., Wang, P., Leung, T. L., Siprashvili, Z., Tichy, A., Li, J., Ameen, M., Hawkins, J., Lee, S., Li, L., Schwertschkow, A., Bauer, G., Lisowski, L., Kay, M. A., Kim, S. K., Lane, A. T., Wernig, M., Oro, A. E. 2014; 6 (264): 264ra163-?

    Abstract

    Patients with recessive dystrophic epidermolysis bullosa (RDEB) lack functional type VII collagen owing to mutations in the gene COL7A1 and suffer severe blistering and chronic wounds that ultimately lead to infection and development of lethal squamous cell carcinoma. The discovery of induced pluripotent stem cells (iPSCs) and the ability to edit the genome bring the possibility to provide definitive genetic therapy through corrected autologous tissues. We generated patient-derived COL7A1-corrected epithelial keratinocyte sheets for autologous grafting. We demonstrate the utility of sequential reprogramming and adenovirus-associated viral genome editing to generate corrected iPSC banks. iPSC-derived keratinocytes were produced with minimal heterogeneity, and these cells secreted wild-type type VII collagen, resulting in stratified epidermis in vitro in organotypic cultures and in vivo in mice. Sequencing of corrected cell lines before tissue formation revealed heterogeneity of cancer-predisposing mutations, allowing us to select COL7A1-corrected banks with minimal mutational burden for downstream epidermis production. Our results provide a clinical platform to use iPSCs in the treatment of debilitating genodermatoses, such as RDEB.

    View details for DOI 10.1126/scitranslmed.3009540

    View details for PubMedID 25429056

  • An open-label study to evaluate sildenafil for the treatment of lymphatic malformations JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY Danial, C., Tichy, A. L., Tariq, U., Swetman, G. L., Khuu, P., Leung, T. H., Benjamin, L., Teng, J., Vasanawala, S. S., Lane, A. T. 2014; 70 (6): 1050-1057

    Abstract

    Lymphatic malformations can be challenging to treat. Mainstay interventions including surgery and sclerotherapy are invasive and can result in local recurrence and complications.We sought to assess the effect of 20 weeks of oral sildenafil on reducing lymphatic malformation volume and symptoms in children.Seven children (4 boys, 3 girls; ages 13-85 months) with lymphatic malformations were given oral sildenafil for 20 weeks in this open-label study. The volume of the lymphatic malformation was calculated blindly using magnetic resonance imaging performed before and after 20 weeks of sildenafil. Lymphatic malformations were assessed clinically on weeks 4, 12, 20, and 32. Both the physician and parents evaluated the lymphatic malformation in comparison with baseline.Four subjects had a lymphatic malformation volume decrease (1.0%-31.7%). In 2 subjects, despite a lymphatic malformation volume increase (1.1%-3.7%), clinical improvement was noted while on sildenafil. One subject had a 29.6% increase in lymphatic malformation volume and no therapeutic response. Lymphatic malformations of all 6 subjects who experienced a therapeutic response on sildenafil softened and became easily compressible. Adverse events were minimal.A randomized controlled trial will be necessary to verify the effects of sildenafil on lymphatic malformations.Sildenafil can reduce lymphatic malformation volume and symptoms in some children.

    View details for DOI 10.1016/j.jaad.2014.02.005

    View details for Web of Science ID 000336030400023

    View details for PubMedID 24656411

  • Characterizing the relationship between free drug samples and prescription patterns for acne vulgaris and rosacea. JAMA dermatology Hurley, M. P., Stafford, R. S., Lane, A. T. 2014; 150 (5): 487-493

    Abstract

    IMPORTANCE Describing the relationship between the availability of free prescription drug samples and dermatologists' prescribing patterns on a national scale can help inform policy guidelines on the use of free samples in a physician's office. OBJECTIVES To investigate the relationships between free drug samples and dermatologists' local and national prescribing patterns and between the availability of free drug samples and prescription costs. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study investigating prescribing practices for acne, a common dermatologic condition for which free samples are often available. The settings were, first, the offices of nationally representative dermatologists from the National Disease and Therapeutic Index (an IMS Health Incorporated database) and, second, an academic medical center clinic without samples. Participants were ambulatory patients who received a prescription from a dermatologist for a primary initial diagnosis of acne vulgaris or rosacea in 2010. MAIN OUTCOMES AND MEASURES National trends in dermatologist prescribing patterns, the degree of correlation between the availability of free samples and the prescribing of brand-name medications, and the mean cost of acne medications prescribed per office visit nationally and at an academic medical center without samples. RESULTS On a national level, the provision of samples with a prescription by dermatologists has been increasing over time, and this increase is correlated (r?=?0.92) with the use of the branded generic drugs promoted by these samples. Branded and branded generic drugs comprised most of the prescriptions written nationally (79%), while they represented only 17% at an academic medical center clinic without samples. Because of the increased use of branded and branded generic drugs, the national mean total retail cost of prescriptions at an office visit for acne was conservatively estimated to be 2 times higher (approximately $465 nationally vs $200 at an academic medical center without samples). CONCLUSIONS AND RELEVANCE Free drug samples can alter the prescribing habits of physicians away from the use of less expensive generic medications. The benefits of free samples in dermatology must be weighed against potential negative effects on prescribing behavior and prescription costs.

    View details for DOI 10.1001/jamadermatol.2013.9715

    View details for PubMedID 24740450

  • Characterizing the Relationship Between Free Drug Samples and Prescription Patterns for Acne Vulgaris and Rosacea JAMA DERMATOLOGY Hurley, M. P., Stafford, R. S., Lane, A. T. 2014; 150 (5): 487-493
  • Gene Therapy for Skin Diseases COLD SPRING HARBOR PERSPECTIVES IN MEDICINE Gorell, E., Ngon Nguyen, N., Lane, A., Siprashvili, Z. 2014; 4 (4)
  • Successful Investigational New Drug Preparation without Reinventing the Wheel JOURNAL OF INVESTIGATIVE DERMATOLOGY Gorell, E. S., Tichy, A. L., Lane, A. T. 2011; 131 (5): 996-998

    View details for DOI 10.1038/jid.2011.38

    View details for Web of Science ID 000289789900002

    View details for PubMedID 21494234

  • Long-Term Type VII Collagen Restoration to Human Epidermolysis Bullosa Skin Tissue HUMAN GENE THERAPY Siprashvili, Z., Nguyen, N. T., Bezchinsky, M. Y., Marinkovich, M. P., Lane, A. T., Khavari, P. A. 2010; 21 (10): 1299-1310

    Abstract

    In spite of advances in the molecular diagnosis of recessive dystrophic epidermolysis bullosa (RDEB), an inherited blistering disease due to a deficiency of type VII collagen at the basement membrane zone (BMZ) of stratified epithelium, current therapy is limited to supportive palliation. Gene delivery has shown promise in short-term experiments; however, its long-term sustainability through multiple turnover cycles in human tissue has awaited confirmation. To characterize approaches for long-term genetic correction, retroviral vectors were constructed containing long terminal repeat-driven full-length and epitope-tagged COL7A1 cDNA and evaluated for durability of type VII collagen expression and function in RDEB skin tissue regenerated on immune-deficient mice. Type VII collagen expression was maintained for 1 year in vivo, or over 12 epidermal turnover cycles, with no abnormalities in skin morphology or self-renewal. Type VII collagen restoration led to correction of RDEB disease features, including reestablishment of anchoring fibrils at the BMZ. This approach confirms durably corrective and noninjurious gene delivery to long-lived epidermal progenitors and provides the foundation for a human clinical trial of ex vivo gene delivery in RDEB.

    View details for DOI 10.1089/hum.2010.023

    View details for Web of Science ID 000282955500008

    View details for PubMedID 20497034

  • The integrity of the dermatology National Resident Matching Program: Results of a national study J Am Acad Dermatol Sbicca, Gorell, Kanzler, lane 2010; 63 (4): 594-601
  • Vitamin D deficiency in the San Francisco bay area JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM McAllister, J. C., Lane, A. T., Buckingham, B. A. 2006; 19 (3): 205-208

    View details for Web of Science ID 000236479400003

    View details for PubMedID 16607919

  • Eczema and Sensitization to Common Allergens in the United States: A Multiethnic, Population-Based Study PEDIATRIC DERMATOLOGY Fu, T., Keiser, E., Linos, E., Rotatori, R. M., Sainani, K., Lingala, B., Lane, A. T., Schneider, L., Tang, J. Y. 2014; 31 (1): 21-26

    Abstract

    The relationship between food and environmental allergens in contributing to eczema risk is unclear on a multiethnic population level. Our purpose was to determine whether sensitization to specific dietary and environmental allergens as measured according to higher specific immunoglobulin E (IgE) levels is associated with eczema risk in children. National Health and Nutrition Examination Survey participants ages 1 to 17 years were asked whether they had ever received a diagnosis of eczema from a physician (n = 538). Total and specific serum IgE levels for four dietary allergens (egg, cow's milk, peanut, and shrimp) and five environmental allergens (dust mite, cat, dog, Aspergillus, and Alternaria) were measured. Logistic regression was used to examine the association between eczema and IgE levels. In the United States, 10.4 million children (15.6%) have a history of eczema. Eczema was more common in black children (p < 0.001) and in children from families with higher income and education (p = 0.01). The median total IgE levels were higher in children with a history of eczema than in those without (66.4 vs 50.6 kU/L, p = 0.004). In multivariate analysis adjusted for age, race, sex, family income, household education, and physician-diagnosed asthma, eczema was significantly associated with sensitization to cat dander (odds ratio [OR] = 1.2, 95% confidence interval [CI] 1.05, 1.4, p = 0.009) and dog dander (OR = 1.5, 95% CI, 1.2, 1.7, p < 0.001). After correction for multiple comparisons, only sensitization to dog dander remained significant. U.S. children with eczema are most likely to be sensitized to dog dander. Future prospective studies should further explore this relationship.

    View details for DOI 10.1111/pde.12237

    View details for Web of Science ID 000330951800017

  • Polyvinylpyrrolidone microneedles enable delivery of intact proteins for diagnostic and therapeutic applications ACTA BIOMATERIALIA Sun, W., Araci, Z., Inayathullah, M., Manickam, S., Zhang, X., Bruce, M. A., Marinkovich, M. P., Lane, A. T., Milla, C., Rajadas, J., Butte, M. J. 2013; 9 (8): 7767-7774

    Abstract

    We present a method of fabricating microneedles from polyvinylpyrrolidone (PVP) that enables delivery of intact proteins (or peptides) to the dermal layers of the skin. PVP is known to self-assemble into branched hollow fibers in aqueous and alcoholic solutions; we utilized this property to develop dissolvable patches of microneedles. Proteins were dissolved in concentrated PVP solution in both alcohol and water, poured into polydimethylsiloxane templates shaped as microneedles and, upon evaporation of solvent, formed into concentric, fibrous, layered structures. This approach of making PVP microneedles overcomes problems in dosage, uniform delivery and stability of protein formulation as compared to protein-coated metallic microneedles or photopolymerized PVP microneedles. Here we characterize the PVP microneedles and measure the delivery of proteins into skin. We show that our method of fabrication preserves the protein conformation. These microneedles can serve as a broadly useful platform for delivering protein antigens and therapeutic proteins to the skin, for example for allergen skin testing or immunotherapy.

    View details for DOI 10.1016/j.actbio.2013.04.045

    View details for Web of Science ID 000322207700017

  • A follow-up survey of the integrity of the dermatology National Resident Matching Program JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY Sbicca, J. A., Gorell, E. S., Peng, D. H., Lane, A. T. 2012; 67 (3): 429-435

    Abstract

    Our group's 2009 study of the integrity of the dermatology match revealed that some dermatology program directors violated National Resident Matching Program (NRMP) policy during their communications with applicants. Our group's article concluded with recommendations to change this behavior.We repeated a survey of dermatology applicants to understand if dermatology program personnel behavior has changed since our group's 2009 study of the dermatology match.We surveyed 2011 applicants to Department of Dermatology, Stanford University, Palo Alto, CA. The survey was anonymous and available online.Of applicants, 14% were asked to reveal how they intended to rank a program before match day. Of applicants, 32% felt pressured to reveal how they intended to rank programs. Of applicants, 90% were asked about interviews at other programs. Of applicants, 44% were asked about their marital status and 19% were asked if they had children or intended to have children.The response rate for applicants was 53%.Although our previous study increased knowledge about the problems within the dermatology match, dermatology program personnel continue to violate NRMP policy. The most widespread violations are asking applicants where they will interview, asking applicants if they are married, and pressuring applicants to reveal how they intend to rank programs. We continue to recommend that programs avoid postinterview contact, and recommend that the NRMP create training videos for applicants and interviewers.

    View details for DOI 10.1016/j.jaad.2011.09.035

    View details for Web of Science ID 000307824000027

    View details for PubMedID 22088426

  • Applying for dermatology residency is difficult and expensive JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY Tichy, A. L., Peng, D. H., Lane, A. T. 2012; 66 (4): 696-697

    View details for DOI 10.1016/j.jaad.2011.10.005

    View details for Web of Science ID 000301444600034

    View details for PubMedID 22421121

  • Sildenafil for Severe Lymphatic Malformations NEW ENGLAND JOURNAL OF MEDICINE Swetman, G. L., Berk, D. R., Vasanawala, S. S., Feinstein, J. A., Lane, A. T., Bruckner, A. L. 2012; 366 (4): 384-386

    View details for Web of Science ID 000299464100029

    View details for PubMedID 22276841

  • The integrity of the dermatology National Resident Matching Program: Results of a national study JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY Sbicca, J. A., Gorell, E. S., Kanzler, M. H., Lane, A. T. 2010; 63 (4): 594-601

    Abstract

    National Resident Matching Program (NRMP) policy outlines the conduct expected by both program directors and residency applicants. However, recent studies and personal experiences have introduced the possibility that NRMP policy is violated during the residency application process.To investigate the communications that occur between dermatology applicants and dermatology programs during the residency application process.From April to July 2009, we surveyed 2009 Stanford dermatology applicants, current US dermatology residents, and US dermatology program directors. The survey was anonymous and available online. The main outcome measures were the frequency and incidence of dermatology NRMP policy violations.Thirty-one percent of Stanford applicants and 19% of US dermatology residents felt pressured to reveal to programs how they ranked them before match day. Seventeen percent of Stanford applicants and 14% of US dermatology residents witnessed behavior that made them feel uncomfortable or that they thought was a possible ethical infraction of NRMP policy.Response rates were as follows: 43% of Stanford applicants, 46% of residents, and 61% of program directors.Our data suggest that some dermatology program directors violate NRMP policy during their communications with applicants. The most widespread violation is pressuring applicants into revealing how they intend to rank programs. Other violations include apparent sexual discrimination and reserving NRMP positions for preselected applicants. Additional studies should be done in order to determine the incidence of dermatology applicants violating NRMP policy.

    View details for DOI 10.1016/j.jaad.2009.11.009

    View details for Web of Science ID 000282069400006

    View details for PubMedID 20599295

  • Diagnosis of Pilomatricoma Using an Otoscope PEDIATRIC DERMATOLOGY Barreto-Chang, O. L., Gorell, E. S., Yamaguma, M. A., Lane, A. T. 2010; 27 (5): 554-557

    Abstract

    Pilomatricoma is a benign tumor that presents as a 3-30-mm, firm, solitary, deep, dermal or subcutaneous tumor on the head, neck, or upper extremities. The clinical diagnosis is often made by the firm, sometimes rock-hard texture of the skin. The diagnosis can be confirmed by a skin biopsy or excision of the lesion. We have recently noted that pilomatricomas appear as a black mass in the skin when the lesion is transilluminated by placing the light of a fiberoptic otoscope adjacent to the skin lesion. To our knowledge, this is the first report demonstrating preoperative diagnosis of pilomatricoma by transilluminating the lesion with an otoscope.

    View details for DOI 10.1111/j.1525-1470.2010.01264.x

    View details for Web of Science ID 000282178800036

    View details for PubMedID 20807359

  • Acquired Bilateral Agminated Spitz Nevi in a Child with Langerhans Cell Histiocytosis PEDIATRIC DERMATOLOGY Berk, D. R., Lane, A. T. 2010; 27 (3): 282-284

    Abstract

    Multiple Spitz nevi are rare and may occur in agminated, widespread, or dermatomal distributions. Agminated Spitz nevi usually arise in children, presenting on grossly normal, hyperpigmented, or most rarely, hypopigmented skin. We present a child with Langerhans cell histiocytosis who developed bilateral agminated Spitz nevi in the inguinal area. Unusual features included the multifocal distribution, bilateral inguinal location, and co-occurrence with Langerhans cell histiocytosis.

    View details for DOI 10.1111/j.1525-1470.2010.01139.x

    View details for Web of Science ID 000278037100012

    View details for PubMedID 20609146

  • Support groups for children and their families in pediatric dermatology PEDIATRIC DERMATOLOGY Goh, C., Lane, A. T., Bruckner, A. L. 2007; 24 (3): 302-305

    Abstract

    Recent discussions regarding the burden of skin disease and patient-centered medicine highlight the profound effects skin disease can have on individuals, their families, and society as a whole. Local support groups, often connected to national patient advocacy groups, can be an invaluable resource for patients, and offer physicians the opportunity to learn more about patients' disease experiences while providing adjunctive therapy for conditions such as alopecia areata and vitiligo, for which medical options are often limited. We created a support group for children with alopecia areata and their parents as a model for other diseases such as vitiligo and epidermolysis bullosa. Herein we outline the steps involved in establishing a support group, including the many resources available for patient support, steps in the recruitment of patients, topics for discussion and goals for the group, and the logistics of running a meeting. Creating this family support group was a relatively straightforward and rewarding experience for us, and we hope that other pediatric dermatologists can utilize this model for their patients.

    View details for Web of Science ID 000247174400021

    View details for PubMedID 17542885

  • Pharmaceutical support of dermatology residency electives: slippery slope or synergy? The virtual mentor : VM Lane, A. T. 2006; 8 (8): 509-511
  • Diaper dermatitis PEDIATRIC CLINICS OF NORTH AMERICA Kazaks, E. L., Lane, A. T. 2000; 47 (4): 909-?

    Abstract

    The primary goals of preventing and treating diaper dermatitis include keeping the skin dry, protected, and infection free. Frequent diaper changes with the superabsorbent disposable diapers may be the best tactic for infants' skin, if not the environment. Also, the more time that infants spend without diapers, the less dermatitis they experience, but a practical balance must be struck. Gentle cleansing and barrier creams are beneficial, and candidal infection must be treated. Finally, any recalcitrant diaper dermatitis must be further investigated to uncover underlying disease (Fig. 6).

    View details for Web of Science ID 000088348800011

    View details for PubMedID 10943265

  • Gene therapy for a lethal genetic blistering disease: a status report. Transactions of the American Clinical and Climatological Association BAUER, E. A., Herron, G. S., Marinkovich, M. P., Khavari, P. A., Lane, A. T. 1999; 110: 86-92

    View details for PubMedID 10344009

  • Skin manifestations of mitochondrial DNA syndromes: Case report and review JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY Flynn, M. K., Wee, S. A., Lane, A. T. 1998; 39 (5): 819-823

    Abstract

    Mitochondrial DNA syndromes are an emerging class of diseases that can present at any age. Clinical findings are legion and may include renal tubulopathy, growth retardation, myopathy, seizures, and ophthalmoplegia. Mitochondrial DNA syndromes have presented with symmetric cervical lipomas, poikiloderma, and anhidrosis. We describe a child with a novel mitochondrial DNA syndrome who had poikiloderma on sun-exposed areas. We also reviewed 274 patients with mitochondrial DNA disorders for skin findings. Symmetric cervical lipomas were consistently associated with myoclonic epilepsy as part of 1 syndrome. With the exception of lipomas, skin findings were reported in 16 patients.

    View details for Web of Science ID 000076813000001

    View details for PubMedID 9810906

  • A young boy with a large hemifacial plaque with histopathologic features of trichoepithelioma JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY Oh, D. H., Lane, A. T., Turk, A. E., Kohler, S. 1997; 37 (5): 881-883

    Abstract

    Trichoepitheliomas commonly appear as sporadic solitary lesions or, more rarely, as multiple lesions that are often dominantly inherited. We describe an 8-year-old boy with multiple facial papules that coalesced into a large plaque. This presentation of multiple trichoepitheliomas may represent an unusual type of nevus.

    View details for Web of Science ID A1997YF41300016

    View details for PubMedID 9366858

  • Warts and molluscum contagiosum - Beware of treatments worse than the disease POSTGRADUATE MEDICINE ORDOUKHANIAN, E., Lane, A. T. 1997; 101 (2): 223-?

    Abstract

    To treat or not to treat, that is the question. Two cutaneous infections, warts and molluscum contagiosum, have evaded eradication for centuries, and the viruses continue to thrive and to expand in number despite all attempts at destruction. Meanwhile, many cases regress spontaneously. In this article, the authors review the characteristics of the viruses involved; discuss their transmission, epidemiology, and clinical manifestations; and assess the effectiveness of available therapies.

    View details for Web of Science ID A1997WJ34700022

    View details for PubMedID 9046937

  • Topical ointment therapy benefits premature infants JOURNAL OF PEDIATRICS Nopper, A. J., Horii, K. A., SOOKDEODROST, S., Wang, T. H., Mancini, A. J., Lane, A. T. 1996; 128 (5): 660-669

    Abstract

    Premature infants have an ineffective epidermal barrier. The aim of this study was to investigate the cutaneous and systemic effects of preservative-free topical ointment therapy in premature infants.We conducted a prospective, randomized study of 60 infants less than 33 weeks' estimated gestational age. The treated infants received therapy for 2 weeks with twice-daily preservative-free topical ointment therapy while the control group received no topical treatment or as-needed therapy with a water-in-oil emollient. Data collection included transepidermal water loss (TEWL) measurement, skin condition evaluations, fungal and quantitative bacterial skin cultures, analysis of fluid requirements, patterns of weight low or gain, and the incidence of blood and cerebrospinal fluid cultures positive for microorganisms.We found that topical ointment therapy significantly decreased TEWL during the first 6 hours after the initial application. TEWL was decreased by 67% (p = 0.0001) when measured 30 minutes after application and 34% (p = 0.001) when measured 4 to 6 hours after application. We also observed significantly superior skin condition scores in the treated group on study days 7 and 14 (p = 0.001) and 0.0004, respectively). Quantitative bacterial cultures revealed significantly less colonization of the axilla on day 2, 3, or 4 and on day 14 (p = 0.008 and 0.04, respectively). The incidence of positive findings in blood and/or cerebrospinal fluid cultures was 3.3% in the treated group of infants versus 26.7% in the control group (p = 0.02). There was no statistical difference in the fluid requirements or patterns of weight gain or loss during the 2 weeks of the study.Preservative-free topical ointment therapy decreased TEWL for 6 hours after application, decreased the severity of dermatitis, and decreased bacterial colonization of axillary skin. Infants treated with ointment had fewer blood and cerebrospinal fluid cultures positive for microorganisms. These data support the use of topical ointment therapy in very premature infants during the first weeks after birth.

    View details for Web of Science ID A1996UJ94600015

    View details for PubMedID 8627439

  • Cutaneous candidiasis PEDIATRIC DERMATOLOGY Lane, A. T. 1995; 12 (4): 369-369

    View details for Web of Science ID A1995TM65500018

    View details for PubMedID 8747589

  • Increased migration of human fetal keratinocytes occurs without accompanying changes in attachment of integrin expression Wounds Lane AT, Drost SS, Chen JD, Woodley DT 1995
  • Infant skin care: When, why and what? PEDIATRIC DERMATOLOGY Lane, A. T. 1995; 1073: 247-250
  • IMPETIGO - AN OVERVIEW PEDIATRIC DERMATOLOGY Darmstadt, G. L., Lane, A. T. 1994; 11 (4): 293-303

    Abstract

    This article reviews in detail the pathogenesis, clinical characteristics and management of impetigo in children. Impetigo is the most common bacterial skin infection of children. Most cases of nonbullous impetigo and all cases of bullous impetigo are caused by Staphylococcus aureus. The remainder of cases of nonbullous impetigo are due to group A beta hemolytic streptococci (GABHS). GABHS colonize the skin directly by binding to sites on fibronectin that are exposed by trauma. In contrast, S. aureus colonizes the nasal epithelium first; from this reservoir, colonization of the skin occurs. Patients with recurrent impetigo should be evaluated for carriage of S. aureus. Superficial, localized impetigo may be treated successfully in more than 90% of cases with topical application of mupirocin ointment. Impetigo that is widespread or involves deeper tissues should be treated with a beta-lactamase-resistant oral antibiotic. The choice of antibiotics is affected by the local prevalence of resistance to erythromycin among strains of S. aureus, antibiotic cost and availability, and issues of compliance.

    View details for Web of Science ID A1994PY11400001

    View details for PubMedID 7899177

  • PROTEUS SYNDROME PEDIATRIC DERMATOLOGY Darmstadt, G. L., Lane, A. T. 1994; 11 (3): 222-226

    Abstract

    A 10-month-old girl had macrodactyly, facial and extremity hemihypertrophy, plantar cerebriform hyperplasia, a subcutaneous mass on the back, macrocephaly, and lumbar kyphosis. These findings were diagnostic of Proteus syndrome. The clinical features, etiology, management, and points of differential diagnosis are discussed.

    View details for Web of Science ID A1994PE28000005

    View details for PubMedID 7971556

  • SEMIPERMEABLE DRESSINGS IMPROVE EPIDERMAL BARRIER FUNCTION IN PREMATURE-INFANTS PEDIATRIC RESEARCH Mancini, A. J., SOOKDEODROST, S., Madison, K. C., SMOLLER, B. R., Lane, A. T. 1994; 36 (3): 306-314

    Abstract

    Infants of less than 32 wk gestation have a defective epidermal barrier, with increased skin permeability and transepidermal water loss (TEWL). We studied the effect of a nonadhesive semipermeable dressing on the epidermal barrier of premature infants and on fetal skin transplanted to nude mice. Fifteen infants with a mean estimated gestational age of 27.7 wk and 16 human fetal skin grafts (estimated gestational age, 23-26 wk) transplanted to eight nude mice were studied. One lower leg (or skin graft) was treated and the other left untreated as a control. In the infants, TEWL was measured on control skin and treated skin (both through the dressing and after temporary dressing removal) on d 0, 1, 2, 4, and 7. Bacterial and fungal cultures were also performed. In the mice, TEWL and skin blood flow were measured on d 0, 2, and 4. Biopsies were obtained on d 4 for a cell proliferation assay, histology, and electron microscopy. Treated infant skin showed a consistently lower bacterial number and a significantly decreased TEWL (measured through the dressing). There was also a significantly lower TEWL on the treated side, measured after temporary dressing removal, on d 1, 2, 4, and 7, documenting improved epidermal barrier function. The animal study revealed decreased TEWL and a nearly 2-fold greater d-4 keratinocyte proliferation (p = 0.01) in treated skin and decreased blood flow on d 4 in control skin (p = 0.01). There was no significant difference in the volume density of membrane coating granules or the morphology of intercorneocyte spaces.(ABSTRACT TRUNCATED AT 250 WORDS)

    View details for Web of Science ID A1994PC73300007

    View details for PubMedID 7808826

  • PICTURE OF THE MONTH AMERICAN JOURNAL OF DISEASES OF CHILDREN Darmstadt, G. L., Lane, A. T., Tunnessen, W. W. 1993; 147 (12): 1339-1339

    View details for Web of Science ID A1993MX51100027

    View details for PubMedID 8249959

  • EFFECTS OF REPEATED APPLICATION OF EMOLLIENT CREAM TO PREMATURE NEONATES SKIN PEDIATRICS Lane, A. T., DROST, S. S. 1993; 92 (3): 415-419

    Abstract

    Emollient cream moisturizers are often used on premature newborns in neonatal intensive care units without accurate knowledge of the risks or benefits to the neonate.We prospectively compared premature neonates treated with a water-in-oil emollient cream for up to 16 days to untreated premature neonates.The study was completed in a neonatal intensive care unit on neonates admitted for respiratory distress and/or possible sepsis.Thirty-four neonates, between 29 and 36 weeks estimated gestational age, entered the study.One-half of the neonates were treated twice a day with an water-in-oil emollient cream, and the other half served as controls.The skin condition of the neonates' hands, feet, and abdomen was evaluated on entering the study and twice a week. Fungal cultures and quantitative bacterial cultures were obtained from the axilla and abdomen on entering the study and twice a week.The mean gestational age of the treated neonates was 32.3 weeks, whereas the mean gestational age of the control neonates was 32.5 weeks. The neonates treated with emollient cream demonstrated statistically less dermatitis of their hands (day 2 through day 11), their feet (day 2 through day 16), and their abdomen (day 7 through day 11). Fungal cultures and quantitative bacterial cultures of the abdomen and axilla were equivalent in both groups.These studies document that emollient cream moisturizer therapy of premature neonates decreases dermatitis without changing the microbiological flora.

    View details for Web of Science ID A1993LV81500011

    View details for PubMedID 8361795

  • CANDIDA AND MALASSEZIA AS NURSERY PATHOGENS SEMINARS IN DERMATOLOGY Stuart, S. M., Lane, A. T. 1992; 11 (1): 19-23

    Abstract

    Candida and Malassezia can be both normal flora and pathogens in the nursery. Very low-birth-weight infants are at high risk for systemic infection from these organisms. We review the microbiology and clinical manifestations of disease within the neonatal nursery.

    View details for Web of Science ID A1992HF18500004

    View details for PubMedID 1550712

  • COMPARISON OF MOMETASONE FUROATE 0.1-PERCENT CREAM AND HYDROCORTISONE 1.0-PERCENT CREAM IN THE TREATMENT OF CHILDHOOD ATOPIC-DERMATITIS JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY Vernon, H. J., Lane, A. T., Weston, W. 1991; 24 (4): 603-607

    Abstract

    We conducted a 6-week randomized, blinded study that compared mometasone furoate 0.1% cream, applied once daily, and hydrocortisone 1.0% cream, applied twice daily, in 48 children with moderate to severe atopic dermatitis. Mometasone furoate, a moderate-potency steroid, produced significantly greater improvement than the low-potency hydrocortisone used twice daily. The difference in therapeutic response was particularly evident in patients with involvement of more than 25% of their body surface area. Morning plasma cortisol levels were assayed before treatment, after 1 week of therapy, and at the end of the clinical trial. Plasma cortisol levels were transiently suppressed in one child who was treated with hydrocortisone and in none of the children treated with mometasone.

    View details for Web of Science ID A1991FD90300016

    View details for PubMedID 2033138

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