Leore Lavin

Background: Student-run clinics (SRCs) for dermatology hold potential to significantly advance skin-related health equity, and a comprehensive analysis of these clinics may inform strategies for optimizing program effectiveness. Objective: We aimed to perform a scoping review of the literature about dermatology SRCs across the United States. Methods: We conducted systematic literature searches of Ovid MEDLINE, Ovid Embase, and Scopus on March 1, 2023, and June 19, 2024. No date, language, or paper-type restrictions were included in the search strategy. A total of 229 references were uploaded to Covidence for screening by 2 independent reviewers (SK and LL), and 23 full-text documents were assessed for eligibility. After an additional 8 documents were identified through a gray literature search, a total of 31 studies were included in the final analysis. Inclusion criteria were as follows: (1) studies set in an SRC, which was operationally led by medical students and could render condition-relevant treatments to patients, with dermatology care; (2) published in English; (3) within the United States; (4) included characterization of any of the following: logistics, care, patients, or design; and (5) included all study or document types, including gray literature that was not peer reviewed (eg, conference abstracts, preprints, and letters to the editor). Exclusion criteria were (1) papers not published in English and (2) those with duplicated data or that were limited in scope or not generalizable. Data were extracted qualitatively using Microsoft Excel to categorize the studies by several domains, including clinic location, demographics, services offered, and barriers to care. Results: There are at least 19 dermatology SRCs across the United States. The most common conditions encountered included atopic dermatitis; acne; fungal infections; benign nevi; psoriasis; and neoplasms, such as basal cell carcinoma, squamous cell carcinoma, and melanoma. Key facilitators for the clinics included faculty oversight, attending physician participation for biopsy histopathology, and dedicated program coordinators. Major barriers included lack of follow-up, medication nonadherence, and patient no-shows. Conclusions: Dermatology SRCs serve a diverse patient population, many of whom are underrepresented in traditional dermatology settings. This scoping review provides insights to help build stronger program foundations that better address community dermatologic health needs.

A 70‐year‐old African American female with a history of stage IV mycosis fungoides in remission presented with a gradually enlarging, red, ulcerated nodule on her right dorsal hand. The lesion was biopsied, and it showed intraepidermal proliferation with cytologic atypia and increased vasculature in the papillary dermis. Immunohistochemical staining indicated a yes‐associated protein 1 (YAP1) rearrangement, confirmed by RNA sequencing, revealing a YAP1::MAML2 (mastermind‐like transcriptional coactivator 2) fusion. The lesion was diagnosed as an eccrine porocarcinoma (EPC). The occurrence of EPCs following radiotherapy or trauma has been documented. This case highlights the importance of considering EPCs in patients with extensive skin treatments and immunosuppression history.

Background: Photodynamic therapy (PDT) with topical δ‐Aminolevulinic acid (ALA) has efficacy in treating basal cell carcinoma (BCC) but is limited by incomplete penetration of ALA into the deeper dermis. This prospective open‐label pilot trial investigated the safety and efficacy of photosensitizer jet injection for PDT (JI‐PDT) for BCC treatment. It was performed with 15 patients (n = 15) with histologically confirmed, untreated, low‐risk nodular BCCs at a single institution.Methods: For the intervention, JI‐PDT patients (n = 11) received two sessions of jet‐injected ALA with PDT separated by four to 6 weeks. To further understand treatment technique, another group of patients (n = 4) received jet‐injected ALA followed by tumor excision and fluorescence microscopy (JI‐E). Treatment tolerability was assessed by local skin responses (LSR) score at five distinct time intervals. Fluorescence microscopy assessed protoporphyrin IX penetration depth and biodistribution within the tumor. At the primary endpoint, tumor clearance was evaluated via visual inspection, dermoscopy and reflectance confocal microscopy. Postinjection and postillumination pain levels, and patient satisfaction, were scored on a 0−10 scale.Results: Fifteen participants with mean age of 58.3, who were 15/15 White, non‐Hispanic enrolled. The median composite LSR score immediately after JI‐PDT was 5 (interquartile range [IQR] = 3) which decreased to 0.5 (IQR = 1) at primary endpoint (p < 0.01). Immunofluorescence of excised BCC tumors with jet‐injected ALA showed photosensitizer penetration into papillary and reticular dermis. Of the 13 JI‐PDT tumors, 11 had tumor clearance confirmed, 1 recurred, and 1 was lost to follow‐up. 1/11 patients experienced a serious adverse event of cellulitis. 70% of patients had local scarring at 3 months. Patients reported an average pain level of 5.6 (standard deviation [SD] = 2.3) during jet injection and 3.7 (SD = 1.8) during light illumination.Conclusions: Jet injection of ALA for PDT treatment of nodular low‐risk BCC is tolerable and feasible and may represent a novel modality to improve PDT.

A unique case of hybrid SEF-LGFMS with a EWSR1-CREB3L1 Fusion and robotic-assisted bronchoscopy in an 11-year-old Authors: Leore Lavin, MS1*, Nithya Krishnamurthy, BA1*, Chantal Spencer Grant, MD2, Kayleen Bailey, MD3Affiliations : 1Icahn School of Medicine at Mount Sinai, 2Mount Sinai Hospital Department of Pediatric Pulmonology, 3Mount Sinai Hospital Department of Pediatric Hematology-Oncology* Both authors contributed equally to this workCorresponding author: Leore Lavin,leore.lavin@icahn.mssm.edu.50 East 98th St. New York, NY 10029. 646-709-8909.Running title: Rare pediatric SEF-LGFMS with EWSR1-CREB3L1 FusionKeywords: Robotic Bronchoscopy, Pediatric Oncology, SEF, LGFMS, EWSR1, CREB3L1Abbreviations: