bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Barictinib As Compared to Conventional Therapy as a Treatment for Alopecia Areata
Authors: Kapur Sahil , Satya-Akunuri Koka Sanjay , Houdi Mark , Kancharla Priyal , Suba Koka Rohith , Burkhart Craig
Published: September 2024

Alopecia Areata (AA) is an autoimmune condition that leads to loss of hair in patches and is linked with psychiatric illnesses including depression and social anxiety disorder. The approval of Baricitinib by the U.S. Food and Drug Administration (FDA) in 2022 has changed the conventional treatment for AA. Importantly, the pathophysiology of AA is tied with the Janus Kinase (JAK) class of enzymes that signal interleukin-15 and interferon-ɣ cytokines which are responsible for inflammation of hair follicles leading to non-scarring, demarcated patches of hair loss. Due to the pathophysiology, conventional treatment options focus on recovery and reducing inflammation of the hair follicles with the usage of corticosteroids. The recent approval of Baricitinib may change conventional therapy as Baricitinib is a JAK inhibitor that interrupts the pathophysiology of AA. Importantly, these trials showed that Baricitinib was suitable for the treatment of AA, but also revealed the potential adverse reaction that may occur to patients that have a specific previous health history. We screened through 19 manuscripts using these keywords: Alopecia Areata pathophysiology, JAK enzymes, interleukin-15, hair follicle inflammation, Baricitinib, Alopecia Areata, clinical trial, efficacy, adverse reactions, safety profile, Baricitinib side effects, and tolerability. This project focuses on the characterization of Baricitinib as opposed to conventional treatments as a therapy option, also discussing potential adverse reactions caused by Baricitinib and the importance of evaluating individual patient history to maintain safety and efficacy while prescribed.
Exploring Preventive Measures and Disease Dynamics of Hereditary Polymorphic Light Eruption in American Indian Children
Authors: Patel Priya , Ayers Ashley , Patel Ravi , Spears Kathleen
Published: September 2024

Hereditary polymorphic light eruption (HPLE) is a condition related to polymorphic light eruption (PLE). Unlike PLE, HPLE is unique to American Indian populations demonstrating autosomal dominant inheritance pattern with incomplete penetrance. Affected individuals possess hypersensitivity to long UV radiation, which heightens the risk for skin damage. Onset is typically childhood and disease severity results in complications including psychosocial trauma, streptococcal pyoderma, and glomerulonephritis. HPLE can be difficult to diagnose due to its overlapping qualities with other conditions, underscoring the importance of accurate diagnosis and management. Preventive measures play critical roles in mitigating disease occurrence and complications. Literature analysis of five articles using PubMed and Google was conducted to understand HPLE among the Native American community, particularly children. Search terms included hereditary polymorphic light eruption, Native Americans, American Indians, polymorphic light eruption, actinic prurigo, UV toxicity, and photosensitivity. Literature delineated the disease process of HPLE and preventive measures. Studies revealed a higher incidence among children/adolescents who presented with rashes within two hours of sun exposure. Rash severity increased as seasons progressed to summertime. It is imperative that affected individuals utilize broad spectrum coverage sunscreen, covering UVA and UVB rays. Other measures proven to be effective include protective clothing, limiting time outdoors during peak sun hours, and using specially formulated lip balm. HPLE creates a unique challenge among American Indian populations necessitating increased awareness and educational strategies to minimize and avoid complications. Providing education on prevention and actively implementing measures can help decrease the complications of HPLE and increase quality of life.
The Dermatologist's Role in Rehabilitation: A Novel Multidisciplinary Treatment Approach Combining Ablative Fractional Laser Resurfacing and Physical Therapy in Managing a Patient with Scar Contracture of the Neck
Authors: Ricles Victoria , Ahmed Sarah , Xiques-Gunshore Lauren , Schiller Carla , Abidi Nadia , Krakowski Andrew
Published: September 2024

Objective: To employ a multidisciplinary approach combining ablative fractional laser resurfacing concurrently with physical therapy to improve functional and cosmetic deficits associated with traumatic scarring status-post parotid cancer treatment. Methods: A 65-year-old female presented to dermatology with scar contracture of the right neck secondary to multiple surgeries and 36 rounds of adjuvant radiation therapy for stage III adenoid cystic carcinoma of the parotid gland. Severe scar-related complications included impaired physical strength, limited range of motion of the neck, and activity intolerance. The patient also reported difficulty with swallowing and limited ability to open her mouth, resulting in a 30-pound weight loss. Ablative fractional laser resurfacing treatments and laser-assisted delivery of triamcinolone in combination and in parallel with physical therapy sessions were initiated. Results: By month five of combination treatment, the patient had objectively decreased scar fibrosis and swelling, decreased facial swelling composite scores, increased range of motion of the neck, and increased right shoulder strength. Subjectively, the patient expressed increased satisfaction in scar appearance, decreased pain, and increased tolerance to activities such as lifting and reaching. Conclusion: Ablative fractional laser resurfacing is a promising adjunct to established interventions for improving functional and cosmetic deficits and quality of life in patients with scar contractures due to its safety profile and efficacy.
Beyond UV Rays: Examining Health Disparities in Melanoma Outcomes Through a Social Lens
Authors: Mishra Manisha , Cacioppo Joseph
Published: September 2024

Melanoma, despite being only 1% of all skin malignancies, is the primary cause of skin cancer-related deaths in the United States. Identifying key risk factors associated with melanoma is crucial to diagnosing and treating it promptly due to its high metastatic potential. One area of emerging research is examining social determinants of health (SDOH) as a risk factor for melanoma. Populations with a higher socioeconomic and educational status are more likely to be diagnosed with melanoma but less likely to be diagnosed with later-stage melanoma and have better survival outcomes. This review synthesizes current research regarding melanoma and the five domains of SDOH – economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context – and its impact on different populations. A comprehensive search was conducted on PubMed and Google Scholar using keywords within the topics of melanoma, skin cancer, social determinants of health, and health disparities. Twenty-seven articles published in peer-reviewed journals since 2014 and written in English were included. While older research focused strongly on the impact that socioeconomic status had on melanoma outcomes, this review found that other facets of SDOH (i.e., health literacy, English language proficiency, differences between rural and urban healthcare, and social networks) play an equally important role in how melanoma impacts individuals. A deeper understanding of the barriers to equitable dermatological care will help to inform and improve future clinical practice and health policies regarding melanoma treatment and outcomes.
Autoimmune Progesterone Dermatitis Following Placement of a Progesterone-eluting IUD
Authors: Etcheverry Maria , Moshell Alan
Published: September 2024

A 26-year-old female with a history of Raynaud’s phenomenon and a family history of autoimmune disease presented with a cyclical facial rash for 10 months following placement of a progesterone-eluting IUD. The rash began 3-4 days before the onset of menses as a crusted, oozing, vesicular rash, and dried out and improved a few days following the onset of menses. The rash began around her eyes and progressively moved to her forehead, cheeks, jaw, and neck as the months on the IUD progressed. Physical exam revealed poorly-demarcated, pink scaly plaques with overlying crust on the mid-forehead, eyes, cheeks, nose, perioral region, and mid-chin. Patch testing and open application testing of personal skincare products at home were negative. ANA was marginally positive 1:40, although the rest of the rheumatologic workup was unrevealing. The patient’s history and exam were suggestive of autoimmune progesterone dermatitis and she planned to have her progesterone-eluting IUD exchanged for a copper IUD the following week. If no improvement, the patient planned to see a gynecologic endocrinologist for contraception with hormonal treatment that suppresses progesterone secretion rather than using progesterone to inhibit ovulation. The patient was lost to follow-up. Autoimmune progesterone dermatitis, also known as progesterone hypersensitivity, is a rare and under-recognized entity that may be triggered by endogenous (menses, pregnancy) or exogenous progesterone/progestin exposure (contraceptives, IVF).1 It may have a variety of clinical presentations and is thought to be IgE-mediated.1 Management may include reduction of exogenous progesterone and symptomatic control.
The Importance of Dermatological Detection of Xanthomas and Xanthelsemas in Pediatric Patients: A Summary of Case Reports
Authors: Morales Joshua , Jackson Stephanie , Dominguez Alejandra , Thomas Talia , Banks Tyra , Baloch Fiza , Sheu Angel , Sreepad Bhavana , Fat Marisa , Nguyen Thien , Rosenbaum Chiara , Furgerson James
Published: September 2024

Diseases such as sitosterolemias, familial hyperlipidemias, and familial hypercholesterolemias are characterized by unique dermatological manifestations, including eruptive xanthomas and xanthelasmas. Although these conditions are relatively rare in dermatology, they hold significant implications for cardiovascular health, potentially leading to fatal outcomes such as atherosclerotic disease, acute coronary syndrome or hypertensive encephalopathy if untreated. These diseases are particularly notable in pediatric populations and effective preventative treatment can be administered if these lipid-related disorders are detected early. This case series summary highlights various case reports to underscore the critical qualitative dermatological findings associated with these lipid disorders in children. By identifying these signs early through comprehensive dermatological examinations, it is possible to initiate preventative treatments that mitigate the risk of severe cardiovascular disease and other systemic diseases later in adulthood. The aim of this case series is to highlight these dermatological indicators clearly, providing dermatologists with a reliable reference for early diagnosis and intervention, thus highlighting the importance of dermatological assessment in preventing serious health outcomes associated with pediatric lipid disorders.
Skin cancer burden among migrant and seasonal farmworkers in the United States: prevalence and risk factors
Authors: Maju Mehar , Brandt-Flores Cameron
Published: September 2024

Migrant and seasonal farmworkers (MSFW) are essential workers greatly contributing to the American agricultural infrastructure but are frequently overlooked within the healthcare system. There are rampant health inequities impacting migrant farmworkers in the United States, particularly chronic diseases, environmental occupational exposures including enhanced sun exposure, and musculoskeletal issues secondary to occupationally-sustained injuries. While the precise demographic composition of MSFW has geographic variance in the U.S., there is a disproportionately higher number of MSFW who are Hispanic, further adding to the inequities experienced by this population. Given the high degree of time spent outdoors and health inequities already faced by migrant farmworkers, this review sought to better understand the burden of skin cancer on this population. A review of Pubmed was conducted with a combination of the following keywords: migrant farmworker, seasonal farmworker, skin cancer, melanoma, squamous cell, carcinoma, and basal cell carcinoma. There were 122 records identified from the literature review. Upon preliminary review, 110 were excluded based on exclusion criteria. The remaining 12 that were included were reviewed for matching inclusion criteria: (1) published in English and (2) discussed skin cancer burden and risk factors for skin cancer among migrant and seasonal farmworkers in the United States. In total, 7 manuscripts met inclusion criteria. Approximately 43% of included papers (n = 7) primarily surveyed migrant farmworkers and found participants were exposed to direct sunlight upwards of 8 hours daily with limited engagement with sun protection measures such as sunscreen and hat use. One study found that one-third of farmworkers surveyed have never had a skin examination completed. Data on skin cancer prevalence and screening methodologies in this population is sparse. Due to a known relationship between agricultural workers and sun exposure and risk factors for skin cancer, the risk for skin cancer is likely elevated in this population. This population is also subject to inequities when accessing health services for prevention and treatment efforts. In conjunction with decreased knowledge regarding risk factors for skin cancer and preventative methods, it is likely that migrant and seasonal farmworkers are at a heightened risk of not only developing skin cancers but less likely at having such malignancies detected early in the disease course. Significantly more data is needed to understand precisely how skin cancer impacts migrant farmworker populations to guide public health interventions aimed to enhance health literacy, sun protection habits, and increased access to dermatologists and dermatologic care.
Exploring the Impact of Pre-existing Allergic Conjunctivitis on the Efficacy of Refractory Medications in Chronic Spontaneous Urticaria: A TrinetX Database Analysis
Authors: Vo Carolynne , Lowe Catherine , Lin Michelle , Pinal Jennifer , Novak Daniel
Published: September 2024

Chronic Spontaneous Urticaria, often characterized by pruritic hives, can significantly impact quality of life [1][4]. Standard treatment involves second-generation antihistamines, but some cases may become refractory, requiring stronger medications such as cyclosporine A [2]. Purpose: To investigate the association of allergic conjunctivitis alongside CSU and use of cyclosporine A compared to those without pre-existing AC in treating CSU, using TrinetX database. Methods: Analysis included ICD-10 codes ‘urticaria, unspecified, ‘idiopathic urticaria,’ or ‘other urticaria’ for patients seen during 2020-2024, with at least two consecutive visits at least 4-6 weeks apart, in addition to receiving a second-generation H1-antihistamine treatment. Compare prevalence of cyclosporine use between two cohorts: AC (+) x urticaria x pretreated with H1 and AC (-) x urticaria x pretreated with H1 and patients with and without AC, requiring the addition of cyclosporine A to H1 for treatment of CSU over an observation period of 5 years. Propensity score matching to pair the two cohorts for age, sex, and race [3]. Results: In AC (+) x urticaria x pretreated with H1 group, there were 38,530 patients, out of which 446 required the addition of cyclosporine treatment, resulting in a risk percentage of 1.158%. In AC (-) x urticaria x pretreated with second-generation antihistamine group, with 415,786 patients, 2,812 required the addition of cyclosporine treatment, resulting in a lower risk percentage of 0.676%. Risk Ratio (RR) is calculated as 1.711, with a 95% confidence interval of (1.55, 1.89). Conclusion: A greater proportion of CSU patients with AC required cyclosporine compared to those without AC.
Harnessing the Power of Exosome Therapy in Dermatology: Current Insights and Future Directions
Authors: Frasier Kelly , Fonceca Haley , Fritts Haily
Published: September 2024

Exosomes, extracellular vesicles containing bioactive molecules such as proteins, lipids, and nucleic acids, have emerged as promising candidates for innovative therapeutic approaches in dermatology. This review examines recent advancements in exosome-based therapies for various dermatological conditions, including wound healing, hair regeneration, and inflammatory skin disorders. A literature review was conducted using PubMed, searching the keywords "exosome therapy dermatology,” “exosome therapy skin conditions,” "exosome therapy wound healing,” "exosome therapy skin inflammation," "exosome therapy hair regeneration," "exosome-based therapeutics", and "exosome formulation." A total of 41 articles were screened for this review. Current research demonstrates the potential of exosomes derived from stem cells, keratinocytes, and fibroblasts in modulating cellular signaling pathways, promoting tissue repair, and regulating immune responses. Moreover, exosome-based formulations offer advantages such as targeted delivery, low immunogenicity, and enhanced stability. Future directions in exosome therapy include optimizing isolation and purification techniques, elucidating mechanisms of action, and exploring novel sources of therapeutic exosomes. Additionally, clinical trials are warranted to evaluate the safety, efficacy, and long-term outcomes of exosome-based treatments, paving the way for personalized and regenerative dermatology.
Basal Cell Carcinoma of the External Auditory Canal and Conchal Bowl
Authors: Abi-Najm Danielle , Bajoghli Amir
Published: September 2024

Basal cell carcinoma (BCC) is the most common cancer in humans, and is the most common cutaneous malignancy in the United States. It affects close to 4 million people per year, or one in five Americans. BCC typically arise in sun-exposed areas of the body, due to damage caused by UV light. Although sunlight exposure is the most predictive risk factor for BCC, it can also occur by other methods, giving rise to BCCs that are not in sun-exposed areas of the skin. This case report describes a BCC located in the conchal bowl with extension into the external auditory canal (EAC), a site that is rare for BCC to occur. We are presenting this case to raise awareness of the fact that BCCs could occur anywhere on the body, and dermatologists as well as other clinicians should be observant in their total-body examinations. In addition, we are emphasizing the fact that treating BCC often is a multi-disciplinary effort, and interdisciplinary communication between dermatologic and surgical teams is key to successfully excise BCC in atypical areas.
The Psychosocial Burden Of Psoriasis: Understanding The Impact On Mental Health And Well-Being
Authors: Kapur Sahil , Satya-Akunuri Koka Sanjay , Kancharla Priya , Houdi Mark , Shah Sajan , Fickert Andrew , Burkhart Craig
Published: September 2024

Psoriasis is a chronic, systemic inflammatory skin condition that is distinguished by scaly, red lesions that can be uncomfortable, itchy, and disfiguring. Psoriasis can influence aspects of one’s life beyond distressful physical symptoms, such as mood and quality of life. Patients diagnosed with psoriasis are 39% more likely to suffer from concomitant depression and 31% of patients are diagnosed with anxiety [1]. Due to physical manifestations, individuals with psoriasis are at increased risk of developing issues of poor social perception and body image stress [2]. Research states that psoriasis flare-ups are sometimes directly linked with bouts of anxiety and depression; conversely, physical symptoms of psoriasis may be attributed to psychosocial issues. For example, depression may cause a lack of proper adherence to treatment and lead to exacerbated inflammation. Understanding the psychosocial aspects of psoriasis may provide pertinent clinical information; thereby, allowing seamless integration of psychiatric treatments for the overall treatment protocol for psoriasis. This project delves into understanding how decreased emotional and social well-being can challenge the proper maintenance and treatment of psoriasis. Further, this paper highlights adaptive coping strategies and social support networks that are key in enhancing treatment viability. Oliver C, Robert PD, Daihung D, et al. The Risk of Depression, Anxiety, and Suicidality in Patients With Psoriasis. Arch Dermatol. 2010;146(8) Hepat A, Chakole S, Rannaware A. Psychological Well-Being of Adult Psoriasis Patients: A Narrative Review. Cureus. 2023
Analyzing Recurrence Rates in Pyoderma Gangrenosum
Authors: Gillespie Jordan , Roland-McGowan Jacyln , Haroon Adeeb , Ortega Loayza Alex
Published: September 2024

Pyoderma Gangrenosum (PG) is a rare skin disease characterized by rapid development of painful skin ulcers with violaceous borders that is often associated with inflammatory disorders.1,2 Treatment involves systemic immunosuppression alongside wound care management.2,3 Despite clinicians’ best efforts in implementing appropriate therapy, PG ulcers can recur, and there is minimal data regarding recurrence rates. We systematically reviewed Embase, MEDLINE, and Cochrane library for cases, case series, and clinical studies of confirmed PG to evaluate for recurrence rates. Recurrence was defined as the appearance of new ulcerations after complete initial healing. Our analysis found 269 studies with 351 patients. Among this cohort, 34 cases (10%) described one or more recurrence episodes. Within these 34 cases, ulcer locations were as follows: 20 (56%) on the lower extremities, 12 (33%) on the trunk, 1 (3%) on the upper extremities, 1 (3%) on the head, and 2 (5%) in unspecified areas. When analyzing the time of recurrence from initial healing, we found that 11 cases (29%) recurred in 3 months or less, 5 (14%) from 3 to 6 months, 1 (3%) from 6 to 12 months, and 7 (19%) after 12 months. 13 cases (35%) did not specify a timeline for recurrence, and 3 cases reported two recurrence episodes. In conclusion, our study investigates PG recurrence patterns and suggests that about 10% of patients with PG might experience recurrence after healing, which supports previously reported data.4 Future directions include the impact of treatment duration and treatment type (topical versus systemic) on recurrence rates.
Rationale of Patient-Initiated Loss to Follow Up in Hidradenitis Suppurativa Patients
Authors: Valdez Lourdes , Richmond Adriana , Do Aissa , Bradford Leticia , Kindred Chesahna
Published: September 2024

Introduction: Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition with a predilection for African American and female patients. HS consists of recurrent abscesses and sinus tracts in intertriginous areas. This condition has debilitating medical and psychosocial consequences, with treatment of severe cases remaining difficult. This may lead to patient frustration and lack of follow-up. This study aims to explore the rationale of HS patient-initiated loss to follow-up. Methods: We identified 72 patients at a single center with dermatologist-diagnosed HS seen within the last 12 months (06/30/2021-06/30/2022). Of those 72 patients, 35 were determined to be severe. Of those 35 patients, 11 were not seen within the last 6 months and thus lost to follow-up. These individuals were polled to explore the rationalization of discontinued treatment. Results: Of the 11 patients with severe HS that were lost to follow up, 4 did not respond after three attempts at contact. Of the remaining 7 patients, 3 (27. 27%) reported discontinued care due to scheduling conflicts, 1 (9.09%) had improvement of symptoms, 1 (9.09%) lost medical coverage, 1 (9.09%) cost, and 1 (9.09%) discontinued care due to a competing comorbidity. Discussion: This study determined that of the 7 patients with severe HS that were reached, the largest contributor to patient-initiated loss to follow-up were scheduling conflicts. Thus, the results reported in this study indicate a need for further research into the proactive dismantling of barriers preventing patients from receiving adequate and effective care.
A Report on the Utilization of Excimer 308 nm Lamp Therapy in Treatment of Early Stage Mycosis Fungoides: A Case Report
Authors: Asare Christina , Valdez Lourdes , Johnson Beverly , Kindred Chesahna
Published: September 2024

Introduction: Mycosis fungoides (MF) is a form of cutaneous T cell non-Hodgkin’s lymphoma that presents as patches in early stages of the disease that can progress into thick plaques and eventually leukemia in later stages. Treatments currently focus on symptom repertoire, as well as disease stage. However, patch stage MF has been shown to be more responsive to phototherapy than plaque stage MF. This report aims to expand the literature regarding the efficacy and safety of early-stage MF treatment with 308-nm excimer lamp. Case Report: A 55-year-old African American woman presented to a private dermatologic practice with a 1-year history of pruritic hyperpigmented patches involving the right and left medial scapular back that was confirmed as patch stage MF via biopsy. Initial treatment consisted of 308-nm excimer lamp phototherapy at a dose of 150MED to the affected area which was gradually increased to a range of 160MED to 190MED over the next 18 weeks at 1 to 3-week intervals. After treatment completion a shave biopsy was performed 5 weeks later which confirmed resolution of MF. Discussion: Excimer lamp phototherapy offers shorter therapy duration, targeted treatment, and low UV exposure. This report aims to demonstrate the potential use, safety, and efficacy of the 308-nm excimer lamp in the treatment of patch stage MF. The positive results observed in this report indicate a need for further research and assessment for the potential use of the 308-nm excimer lamp as a therapeutic for early-stage MF.
Facial angiosarcoma: A unique, non-purpuric presentation with good prognosis and unconventional management.
Authors: Gomez-Lara Alexander , Khandpur Ritika
Published: September 2024

Cutaneous angiosarcoma is a rare, aggressive malignant neoplasm of vascular endothelial cell origin with a poor prognosis. The typical presentation of cutaneous angiosarcoma involves a progressive, bruise-like lesion on the head or neck.1 We present an atypical case of facial angiosarcoma in a 79-year-old white male arising as an asymmetric, non-purpuric swelling of the left nasal tip and ala, resembling an asymmetric rhinophyma. Several studies comparing face and scalp angiosarcomas have shown improved prognosis when angiosarcoma occurs on the face.2 Our case supports this trend noted in the literature. Angiosarcoma is typically treated with multiple modalities including surgery, radiotherapy, and chemotherapy. Our patient’s angiosarcoma was controlled with debulking surgery, radiation therapy, and Pembrolizumab (off-label use of immunotherapy). Patient is doing well 4 years later and will resume surgery or radiation if needed for any recurrence.
Subcutaneous Granuloma Annulare: A Systematic Review on Current Treatments
Authors: Woolhiser Emily , Click Kathleen , Patel Arpita
Published: September 2024

Subcutaneous Granuloma Annulare (SGA) is a rare subset of Granuloma Annulare (GA), presenting most often in female children and young adults as a benign, nodular lesion. Etiology is unknown but can be linked to stress, immunologic disorders, connective tissue diseases and diabetes. We searched Scopus, PubMed, Embase, and OVID Medline to assess the current landscape of SGA treatment. We searched (“subcutaneous granuloma annulare” OR “pseudorheumatoid nodules” OR “deep granuloma annulare” OR “palisading granuloma”) AND (“treatment” OR “topical” or “injection”). Articles were limited to English language and human subjects. 302 unique studies were screened and assessed for eligibility by two reviewers working independently with disagreements resolved by a third reviewer’s decision. 33 articles met inclusion comprising case reports (n=27), case series (n=3) and retrospective case reviews (n=3) with a total of 149 patients involved. The most predominant treatment was surgical excision/biopsy (n=112) followed by steroid injection (n=6), topical steroid (n=5), and topical antibiotic (n=3). Reports of one patient responding to treatment (n=1) were reported for local hyperthermia, hydroxychloroquine, cyclophosphamide, oral isotretinoin, PUVA light therapy, and pentoxifylline. Of patients studied in these cases, 17 had spontaneous resolution of their lesions either after the treatment window or before starting treatment. One patient was refractory to targeted treatment but had resolution after achieving diabetic control. While surgical excision predominated, biopsy is standard for diagnosis but follow up was not consistent to assess recurrence. Our review calls for more trials and treatment options for SGA.
The Effects of OnabotulinumtoxinA on Anxiety: A Systematic Review and Quantitative Analysis
Authors: Spoer Daisy , Cach Gina , Umstead Kendall , Rohrich Rachel , Marable Julian , Schwartz Rachel , Berger Lauren , Fan Kenneth , Jabbour Samer
Published: September 2024

Background: Psychopathological symptoms can exacerbate or induce cutaneous disorders. The side effect profile of psychiatric medications may reduce compliance in patients with primarily dermatologic complaints. OnabotulinumtoxinA injections are a common dermatologic intervention that recently demonstrated efficacy in reducing depressive symptoms. This systematic review investigates the anxiolytic effects of onabotulinumtoxinA in patients with comorbid anxiety. Methods: Following PRISMA guidelines, databases including APA PsycInfo, Embase, and PubMed were searched using MeSH terms related to onabotulinumtoxinA and anxiety. English-language primary research that examined the effects of onabotulinumtoxinA on anxiety was selected. Data regarding study design, participant demographics, indications, dosage, and anxiety scores were analyzed. Results: From 677 citations, 32 studies involving 41 patient groups met the criteria for inclusion in this review. The average population was 46 ± 14 years old and female (70 ± 24%). The most common indications for onabotulinumtoxinA included pain (46.3%) and chronic migraines/headaches (34.1%) with a mean dose of (251 ± 368 U). The severity of anxiety was assessed with validated scales in 94% and 81% of patients pre- and post-injection, respectively. At 4 ± 5 months post-onabotulinumtoxinA, 63% of patient groups revealed significant reductions in anxiety. Transient pain and muscle stiffness were the most common side effects, reported in 41.5% of groups. Conclusion: OnabotulinumtoxinA is a promising anxiolytic with a mild side effect profile. Further research will be needed to detail its efficacy relative to specific dermatologic indications, injection locations, and lasting effects.
Characterization of Disparities, Diagnoses and Treatment Outcomes with Pemphigus Vulgaris
Authors: Morales Joshua , Dominguez Arturo
Published: September 2024

Pemphigus vulgaris (PV) and foliaceus (PF) are classified as rare autoimmune blistering disorders in which IgG antibodies destroy desmosome proteins desmoglein 1 and desmoglein 3 within the stratum spinosum of the epithelial layer of the skin. These disorders once used to be a fatal condition, but the advent of steroids and immunosuppressants has made these diseases manageable. Such treatments, however, only alleviate symptoms and have not been viable in allowing patients to achieve prolonged steroid-free remission. In 2018, the US Food and Drug Administration (FDA) approved the anti-CD20 monoclonal antibody rituximab as the first-line treatment for moderate to severe cases of pemphigus. While rituximab has been generally successful in treating this disease and has led to prolonged steroid-free remission in many patients, treatment disparities and differences in patient outcomes due to social determinants of health have not yet been studied in the context of PV and PF. Such studies have already been conducted with more common dermatological disorders such as hidradenitis suppurativa (HS), which show significant evidence of outcome disparities due to social factors such as race, ethnicity and socioeconomic status. However, such studies have yet to be conducted with pemphigus likely because of how rare the disease is and because the current first-line treatment was FDA approved recently in 2018. The aim of this study is to conduct a retrospective multivariable analysis of 100 patients with pemphigus from UT Southwestern Medical Center and Parkland County Hopital to determine which social factors are the most responsible for any discovered pemphigus treatment outcome disparities. The impacts of this study are far-reaching as any discovered disparities can alert dermatologists to place a special emphasis to address any social factors that may play a role in leading to treatment outcome differences for patients with pemphigus.
Impact of Technological Anxiety and Alien Invasion in H.G. Wells's The War of the Worlds.
Authors: Maheshwar Singh  , Dr. Nisha Gupta
Published: September 2024

The term science fiction is applied to those narratives in which unlike in pure fantasy an explicit attempt is made to render plausible the fictional world by reference to known, or imagined scientific principles, or to a projected advance in technology, or to a drastic change in the organization of society A Glossary of Literary Terms, Pg. 355. The science fiction has always a very important thematic topic about Alien invasion and their repercussions. Alien has always plundered or made humans slave while invading Earth in most of the books and movies. The book The War of the World’s speculates on this particular theme of Alien invasion on Earth by H. G. Wells. In the book The War of the Worlds a meteor lands on Earth in Horsell Common near to narrator’s house which later turns out to be an artificial cylinder launched towards Earth having Aliens in them. They invade earth to plunder the resources and to reign on Earth. The research paper will work on the title The Impact of Technological Anxiety and Alien Invasion in H.G. Wells's The War of the Worlds while looking for sub themes like, Technological Anxiety in the 19th Century, alien technologies, Comparative Analysis of Technological and  Extraterrestrial Threats, and human adaptation. At the end the research paper we will see how Wells’s narrative ultimately reflects the broader anxieties of his time, revealing how technological progress and the unknown can together reshape our life.
Genocide and resistance Nr. 40(2)
Authors: Jaskelevičius Tadas , Braslauskas Justinas , Petrauskienė Aistė , Klumbys Valdemaras , Ereminas Gintautas
Published: September 2024

Full Issue
Fates of the Participants of the 1941 June Uprising in Pušalotas Rural Area of Panevėžys County
Authors: Jaskelevičius Tadas
Published: September 2024

The arrival of the German army to the rural area of Pušalotas marked the end of the June 1941 Uprising. This however, was not the end of anti-Soviet activities of the partisans. They continued to arrest the retreating Soviet soldiers and Soviet activists or other suspects who lived in Pušalotas rural area. While the activities of the former participants of the Uprising were similar to those during the Uprising, they were only possible because they met the needs of the new occupation authorities. The most intensive period of activities of former insurgents was during the first few months of the Nazi occupation. At that time the majority of insurgents operated within the auxiliary squad and police units of the German occupation authorities. In this period, some of them also took part in the killings of the civilian population organised by the occupation authorities. The lack of archival data and the fact that not all information in the documents could be considered reliable prevent from identifying the exact number of such people and their motivation. Eventually the insurgents started to realise that the Nazis did not bring independence to Lithuania. At the end of 1941, anti-German moods became stronger, but did not develop into a more serious resistance movement.
The arrival of the Soviet Army to Lithuania in 1944 became another critical moment in the lives of the insurgents. Some of them left Lithuania together with the retreating Germans and later, in the post-war years, settled in West Germany, United States of America, Canada and Australia. Others decided to stay in their home country. Some of the former insurgents joined the partisans in the forests, others were recruited to the Red Army. Arrests of the former participants of the 1941 June Uprising was one of the priorities of the Soviet authorities which occupied Lithuania for the second time. Between 1944 and 1950, the majority of insurgents from Pušalotas rural area were detained. All of them faced criminal charges, but sentences for the same charges varied. Collective liability, where other family members were also sentenced for the person’s crimes, an exclusive phenomenon of the Soviet legal system, was applied. Only in 1990, when Lithuania restored its independence, was it possible to exonerate the participants of the 1941 June Uprising in Pušalotas (except for the persons sentenced for the participation in the massacre of civilians), but only a few lived to see this day.
Freedom Fighter and Location: a Different Story of Partisan Commander Petras Bartkus
Authors: Petrauskienė Aistė
Published: September 2024

The subject of the research in this article is the locations of the partisan warfare determined by the historical events of mid-20th century. The main aim of the research is to highlight the diversity and abundance of the locations of the partisan warfare based on the field data, oral history, archival documents and historical literature. In order to outline the significance of these locations, the case of Petras Bartkus, member of the presidium of the Council of the Movement of the Struggle for Freedom of Lithuania, was selected. The story starts at his birthplace in Pakapurnys Village (Raseiniai District) in 1925 and ends in 1991 in the cemetery of the town of Radviliškis, where the remains of those who had perished in Užpelkių Forest on 13 August 1949 were buried.
The partisan warfare theatre connects various locations of the partisan warfare and allows us to speak about a coherent and homogeneous theatre rather than its individual episodes (bunkers and individual locations of the battles, places of death, etc.). Within the area divided by the war, some locations with encoded values and memories about them emerged, which have been included in the general narrative of the fights for freedom and stand out as places of historical memory.
Archival and field studies make it possible to expand and provide more details to the space in which Bartkus operated, and subsequently to bring people back into the coherent historical partisan warfare narrative. The text lists the locations visited by Bartkus (and there are certainly more of them) and their diversity and abundance supports the thought that the landscape of freedom fights has been unduly diminished. The text mentions 37 places which are better known or which have been identified and 10 more general places, most of which are directly linked to Bartkus’ activities. They can be allocated to 13 different groups, such as his birthplace, camps, bunkers, shelters, locations of the archives, farmsteads of supporters, contact points, places of meetings, battles, places of death and desecration of dead bodies, and places of burial.
Bartkus’ case study brings back an important perception of space during the years of the partisan war, which, after the restoration of an independent state, was generally reduced to the perception consisting of the places of death and burial. A rather comprehensive discussion of Barkus’ life provides supporting details to the environment in which freedom fighters operated, diversity of locations, their change depending on the person’s rank and time of operational activities. Bartkus’ example shows that the perception of the locations of the partisan warfare, which have so far been described as possible locations, but not necessarily existing locations, should be reconsidered. Where possible, the priority should be given to partisan documents, oral history, and field studies, while the documents of the Soviet security structures must be used for the search of additional information.
Assumptions and Formation of the Aesopian Language in the Soviet Lithuania
Authors: Klumbys Valdemaras
Published: September 2024

The article analyses the genesis of the Aesopian language in Lithuania. The rudiments of the Aesopian language existed prior to the Soviet occupation, but there were no established traditions for the creation and use of such language. This gives rise to the question how the Aesopian language with its coherent code system, which was more or less understood by totally unrelated people, could have been created and spread in the repressive Soviet system. The study has shown that it was the Soviet regime that not only created premises and conditions conducive to the Aesopian language, but actually taught the grammar and lexis of this language.
First, the Stalin regime taught to treat people, actions and texts with suspicion. The regime taught this both directly through the pursuit of enemies of the regime and wide-spread suspicion, and indirectly – through the fear of reprisals and distrust among people. Second, the regime strongly politicised all texts and actions. It is also important that politisation was achieved through reinterpretation of the texts or actions. As a result, a habit and skill to easily change meanings was instilled, which is an important mechanism of the Aesopian language. Third, by disclosing enemies and the inconsistencies between the texts and the prevailing ideological discourse, the regime also taught people specific codes by indicating what the regime found unacceptable and how specifically this was encoded and expressed.
The Aesopian language came into operation when the public took over all these characteristics implemented by the regime. Several stages in the functioning of the Aesopian language could be identified. Initially, the interpretative clichés implemented by the regime were used, except that the assessment was exactly the opposite to the official assessment. Subsequently, the mechanisms implemented by the regime were used creatively and new Aesopian codes were created.
It took about two decades (1940s–1950s) to learn the Aesopian language, although examples of its individual use can be found at the very beginning of the Soviet occupation. However, the Aesopian language could spread widely and become systematic only after the in-depth Sovietisation of the Lithuanian society, when Lithuania became fully immersed in the Soviet culture and took over Soviet practices. Therefore, the use of the Aesopian language meant further and deeper reproduction of the Soviet culture despite that the language sought to criticise the regime.
Activity of St. Casimir society in in Vilnius region (1916-1940)
Authors: Ereminas Gintautas
Published: September 2024

The subject of the research is the educational work of the Lithuanian Society of St. Casimir in the difficult conditions of the Polish-ruled Vilnius region. Based on the materials of the Lithuanian Society of St. Casimir in the Manuscripts Department of the Wroblewski Library of the Lithuanian Academy of Sciences, the aim is to reconstruct the activities of the Society in the Vilnius region.
Genocide and resistance Nr. 41(1)
Authors: Černius Remigijus , Pocius Mindaugas , Zagreckas Rimantas , Indrišionis Darius , Jurkutė Jurkutė
Published: September 2024

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Tuskulėnai Mass Burial Grounds Occurence: 1944 or 1945?
Authors: Černius Remigijus
Published: September 2024

The purpose of this article is to establish the date when Soviet secret police agencies started to use the territory of Tuskulėnai Manor as mass burial grounds in Vilnius. The remains of people executed at the inner prison of the NKGB (MGB) of Lithuanian Soviet Socialist Republic were buried there. At the same time, another question had to be answered: who choose this place, Tuskulėnai Manor, as a location suitable for mass graves.
Historiographical sources frequently apply a simplified scheme, stating that the territory of Tuskulėnai Manor started to be used as mass burial grounds from the date when at the inner prison of the NKGB of Lithuanian Soviet Socialist Republic death penalties started to be carried out, i.e., from the 28th September 1944. Still, when analysing more closely the data of archeologic excavations 1994-1996 in the territory of Tuskulėnai Manor, as well as reports of 2003 and NKGB (MGB) documents, some doubts occur whether there could be remains of 45 people buried that had been executed at secret police inner prison in September –December of the year 1944. Statistical analysis allows us to think than in autumn and winter of 1944, the territory of Tuskulėnai Manor had not been used for mass graves. NKGB (MGB) officers could bury the remains of the executed people employing other ways that had not been new for them: in single graves in the woods in Vilnius neighbourhood or in old cemeteries. Such methods were applied by the Soviet secret police agencies from the year 1950.
Historiographical sources claim that the territory of Tuskulėnai Manor had been chosen for mass graves by Ivan Tkachenko, a lieutenant general, who had been appointed an authorized person by NKGB and NKVD of the USSR for Lithuanian Soviet Socialist Republic. This fact is confirmed in the documents of the Soviet secret police institutions. Still, there is no exact date of choosing this location indicated in these documents. I. Tkachenko, to coordinate activity of the repressive structures as an authorized person to Lithuanian Soviet Socialist Republic was appointed on 14th December 1944, while execution of prisoners at the inner prison of NKGB of Lithuanian Soviet Socialist Republic started on 28th September 1944. Such a chronological mismatch suggests that I. Tkachenko selected the territory of Tuskulėnai Manor for mass graves at the end of 1944 or at the beginning of 1945. New documents found in the archives confirm that Tuskulėnai Manor was handed over to the NKGB of Lithuanian Soviet Socialist Republic in January of 1945. Therefore, it can be stated, that the remains of people executed in the inner prison of the NKGB of Lithuanian Soviet Socialist Republic, first had been buried in the territory of Tuskulėnai Manor in January of 1945, while before that date, the Soviet secret police agencies applied different methods.
A role played by the All-Union Communist Party (Bolsheviks) Central Committee Bureau for Lithuania in suppressing resistance of partisans (November 1944–March 1947)
Authors: Pocius Mindaugas
Published: September 2024

The article examines the role of one of the main administrative institutions of the Soviet occupation, the All-Union Communist Party (Bolsheviks) Central Committee Bureau for Lithuanian Affairs, in organising the suppression of the anti-Soviet resistance in 1944– 1947. The research attempts to reveal how the fight against the resistance was managed, what solutions were proposed by the Moscow emissaries, what was their influence in suppressing the resistance, and what was the role of the ACP(B) CC Bureau for Lithuanian Affairs within the overall system of repression.