Coexisting Sickle Cell Anemia and Sarcoidosis: A Management Conundrum!

Sickle cell disease and Sarcoidosis are conditions that are more common in the African American population. In this report we share an unfortunate patient who had hepatic sarcoidosis but could not receive steroids since that precipitated acute liver failure. We have discussed potential therapy options but we need more options that improve mortality

Dermatologic Manifestations of Rheumatic Disease: Cutaneous Manifestations of Vasculitides

Cutaneous Manifestations of Vasculitides is a Powerpoint based learning module that begins with the definition of terms and findings often found in vasculitis, followed by a review of several systemic vasculitides, highlighting how characteristic cutaneous lesions may be predictive of the vessel of involvement as well as the associated histologic changes. Moreover, significant clinical and laboratory findings utilized to make the correct diagnosis will be emphasized. This module is not meant to be an exhaustive review of vasculitis, but to serve as an introduction to understanding disease processes and how systemic vasculitis and skin findings interrelate. It is part of the Dermatologic Manifestations of Rheumatic Disease project, which provides overviews of the identification, diagnosis, and workup for different rheumatologic diseases, with a focus on providing examples from persons of color (POC). The project is a tailored resource for medical learners that addresses a longstanding educational deficit in diverse representation. The OERs will enable us to train future physicians who are not only clinically astute, but also knowledgeable of and sensitive to inequities in healthcare. Ultimately, it is our hope that these OER will aid in fostering a generation of physicians who are truly patient-advocates

Dermatologic Manifestations of Rheumatic Disease: Connective Tissue Disease

This OER is a part of the Dermatologic Manifestations of Rheumatic Disease project, which provides overviews of the identification, diagnosis, and workup for different rheumatologic diseases, with a focus on providing examples from persons of color (POC). This work seeks to fill gaps and exclusionary practices in medical education practices and resources and diagnostic frameworks in regards to skin of color. This lack of representation bodes significant repercussions on the ability of future physicians to deliver equitable care for an increasingly diverse US population. Each module consists of a similar Powerpoint format, which includes key objectives, hypothetical disease cases, an overview of the pathophysiology, dermatologic features, and sequelae of these conditions, and clinical pearls regarding disease management. Overall, the goal of this project is to provide a tailored resource for medical learners that addresses a longstanding educational deficit. The OERs will enable us to train future physicians who are not only clinically astute, but also knowledgeable of and sensitive to inequities in healthcare. Ultimately, it is our hope that these OER will aid in fostering a generation of physicians who are truly patient-advocates. This module on Connective Tissue Disease goes over findings in systemic lupus erythematosus, dermatomyositis, and systemic sclerosis. Included in this module is a slide deck filled with information for a lecture or self study, a practice test, a glossary of terms, as well as a summary of notes for quick studying. It takes approximately 25 minutes to complete. Some images have been removed due to copyright restrictions. When available, the citation for the image was included. The module may be updated as openly licensed images illustrating the discussed topics become available. Students are welcome to find images on VisualDx, the American College of Rheuematology Image bank, and the University of New Mexico Image Bank. This module was created for use in the VCU School of Medicine M1 Movement block, Rheumatology and Dermatology sections. The creation of the Dermatologic Manifestations of Rheumatic Disease project was sponsored in by the part by the 2021 and 2022 Affordable Course Content Awards program. For additional information about the program, please visit guides.library.vcu.edu/acca

Development of a skin-directed scoring system for Stevens-Johnson syndrome and epidermal necrolysis: a Delphi consensus exercise

Importance Scoring systems for Stevens-Johnson syndrome and epidermal necrolysis (EN) only estimate patient prognosis and are weighted toward comorbidities and systemic features; morphologic terminology for EN lesions is inconsistent.Objectives To establish consensus among expert dermatologists on EN terminology, morphologic progression, and most-affected sites, and to build a framework for developing a skin-directed scoring system for EN.Evidence Review A Delphi consensus using the RAND/UCLA appropriateness criteria was initiated with a core group from the Society of Dermatology Hospitalists to establish agreement on the optimal design for an EN cutaneous scoring instrument, terminology, morphologic traits, and sites of involvement.Findings In round 1, the 54 participating dermatology hospitalists reached consensus on all 49 statements (30 appropriate, 3 inappropriate, 16 uncertain). In round 2, they agreed on another 15 statements (8 appropriate, 7 uncertain). There was consistent agreement on the need for a skin-specific instrument; on the most-often affected skin sites (head and neck, chest, upper back, ocular mucosa, oral mucosa); and that blanching erythema, dusky erythema, targetoid erythema, vesicles/bullae, desquamation, and erosions comprise the morphologic traits of EN and can be consistently differentiated.Conclusions and Relevance This consensus exercise confirmed the need for an EN skin-directed scoring system, nomenclature, and differentiation of specific morphologic traits, and identified the sites most affected. It also established a baseline consensus for a standardized EN instrument with consistent terminology