clay cockerell - Academia.edu (original) (raw)

Papers by clay cockerell

Research paper thumbnail of Desmoplastic Malignant Melanoma Clinically Presenting as a “Cyst”

SKIN The Journal of Cutaneous Medicine, 2022

Research paper thumbnail of A Case of Granulomatous Hypersensitivity Reactions to a Dermal Filler Precipitated by PD-1 Checkpoint Inhibitor Therapy

SKIN The Journal of Cutaneous Medicine, 2021

Injection of filler material has become routine in dermatology in improving the appearance of rhy... more Injection of filler material has become routine in dermatology in improving the appearance of rhytides and increasing skin volume associated with aging. While the vast majority of injections are accomplished without complications, foreign body reactions may develop in a certain percentage of individuals. We recently encountered a 65-year-old woman with recurrent malignant melanoma who presented with marked thickening along the sides of her face for approximately 2 months. She recently received nivolumab infusions for recurrent malignant melanoma and noted that symptoms worsened after each infusion. She reported having had cosmetic procedures done three years prior, one of which was an injection of a long-lasting dermal filler, polymethylmethacrylate microsphere enhanced bovine collagen (Bellafill). A biopsy of two areas revealed nodular infiltrates of histiocytes with small round lobules recognizable as polymethylmethacrylate microspheres. Based on clinical and histopathologic fin...

Research paper thumbnail of Considerations for Dermatologic Patient Care during COVID-19

SKIN The Journal of Cutaneous Medicine, 2020

Research paper thumbnail of Dysmorphic Trichophyton rubrum mimicking Blastomycosis

SKIN The Journal of Cutaneous Medicine, 2020

We will describe a 62 year old immunocompromised, diabetic, male patient who presented with sever... more We will describe a 62 year old immunocompromised, diabetic, male patient who presented with several cutaneous lesions. The patient was 4 years post-nephrectomy due to renal cell carcinoma and 6 months post-renal transplantation at time of presentation. Initial clinical impression was thought to be deep fungal infection or metastatic carcinoma. Trichophyton rubrum with a dysmorphic morphology simulating blastomycosis was ultimately diagnosed.

Research paper thumbnail of Review of Instructive Cases from the Zola Cooper and Lee T. Nesbitt Seminar

SKIN The Journal of Cutaneous Medicine, 2019

Histopathological examination is considered to be the gold standard for diagnosis. However, resea... more Histopathological examination is considered to be the gold standard for diagnosis. However, research has shown that clinical correlation with pathological examination is crucial for the appropriate diagnosis. This is especially true in dermatology/dermatopathology where several entities can appear similar under the microscope, but are vastly different with their clinical presentation and vice versa. With this in mind, we mention the Zola Cooper- Lee T. Nesbitt Seminar that was established in 1954 and is the longest free standing clinical-pathologic conference still in existence. The purpose of the seminar is to serve as an educational conference designed to promote continuous excellence in the field of clinical dermatology and dermatopathology. Herein, we present six cases that were presented at the conference which highlight the importance of the clinical-pathological correlation in the practice of dermatology.

Research paper thumbnail of Development and Validation of a Diagnostic 35-Gene Expression Profile Test for Ambiguous or Difficult-to-Diagnose Suspicious Pigmented Skin Lesions

SKIN The Journal of Cutaneous Medicine

Purpose: A clinical hurdle for dermatopathology is the accurate diagnosis of melanocytic neoplasm... more Purpose: A clinical hurdle for dermatopathology is the accurate diagnosis of melanocytic neoplasms. While histopathologic assessment is frequently sufficient, high rates of diagnostic discordance are reported. The development and validation of a 35-gene expression profile (35-GEP) test that accurately differentiates benign and malignant pigmented lesions is described. Methods: Lesion samples were reviewed by at least three independent dermatopathologists and included in the study if 2/3 or 3/3 diagnoses were concordant. Diagnostic utility of 76 genes was assessed with quantitative RT-PCR; neural network modeling and cross-validation were utilized for diagnostic gene selection using 200 benign nevi and 216 melanomas for training. To reflect the complex biology of melanocytic neoplasia, the 35-GEP test was developed to include an intermediate-risk zone. Results: Validation of the 35-GEP was performed in an independent set of 273 benign and 230 malignant lesions. The test demonstrated ...

Research paper thumbnail of Sentinel lymph node biopsy as an adjunct to management of histologically difficult to diagnose melanocytic lesions: A proposal

Journal of the American Academy of Dermatology, 2000

Research paper thumbnail of Actinic Keratoses and the Incidence of Occult Squamous Cell Carcinoma: A Clinical?Histopathologic Correlation

Dermatologic Surgery, 2006

BACKGROUND The ability to clinically diagnose actinic keratoses (AKs) lesions has been taken for ... more BACKGROUND The ability to clinically diagnose actinic keratoses (AKs) lesions has been taken for granted for some time. The importance of the malignant potential of these lesions is well known. However, a recent Phase IV, multicenter study assessing the long-term benefit of aminolevulinic acid–based photodynamic therapy provided a unique opportunity to prospectively examine the clinical histopathologic correlation of AKs.OBJECTIVE The objective was to characterize the histopathology of clinically diagnosed AK lesions in the study population.METHODS Punch biopsies of 220 clinically diagnosed untreated AKs were performed at baseline plus 51 lesions unresponsive to treatment (total, 271).RESULTS Clinical diagnosis and histopathologic findings agreed in 91% (246/271) of the lesions biopsied. The balance of the biopsied lesions were: (1) benign changes 4% (11/271) and (2) occult cutaneous malignancy in 5% (14/271) of the cases, 12 squamous cell carcinomas and 2 basal cell carcinomas.CONCLUSIONS In this study, about 1 in 25 clinically diagnosed AK lesions identified by board-certified dermatologist investigator(s) were occult early-stage squamous cell carcinomas on histologic assessment, a fact surmised by the medical community that until now had not been well quantified. These findings should be considered when clinicians decide how to treat and manage AK patients.

Research paper thumbnail of Desmoplastic Malignant Melanoma Clinically Presenting as a “Cyst”

SKIN The Journal of Cutaneous Medicine, 2022

Research paper thumbnail of A Case of Granulomatous Hypersensitivity Reactions to a Dermal Filler Precipitated by PD-1 Checkpoint Inhibitor Therapy

SKIN The Journal of Cutaneous Medicine, 2021

Injection of filler material has become routine in dermatology in improving the appearance of rhy... more Injection of filler material has become routine in dermatology in improving the appearance of rhytides and increasing skin volume associated with aging. While the vast majority of injections are accomplished without complications, foreign body reactions may develop in a certain percentage of individuals. We recently encountered a 65-year-old woman with recurrent malignant melanoma who presented with marked thickening along the sides of her face for approximately 2 months. She recently received nivolumab infusions for recurrent malignant melanoma and noted that symptoms worsened after each infusion. She reported having had cosmetic procedures done three years prior, one of which was an injection of a long-lasting dermal filler, polymethylmethacrylate microsphere enhanced bovine collagen (Bellafill). A biopsy of two areas revealed nodular infiltrates of histiocytes with small round lobules recognizable as polymethylmethacrylate microspheres. Based on clinical and histopathologic fin...

Research paper thumbnail of Considerations for Dermatologic Patient Care during COVID-19

SKIN The Journal of Cutaneous Medicine, 2020

Research paper thumbnail of Dysmorphic Trichophyton rubrum mimicking Blastomycosis

SKIN The Journal of Cutaneous Medicine, 2020

We will describe a 62 year old immunocompromised, diabetic, male patient who presented with sever... more We will describe a 62 year old immunocompromised, diabetic, male patient who presented with several cutaneous lesions. The patient was 4 years post-nephrectomy due to renal cell carcinoma and 6 months post-renal transplantation at time of presentation. Initial clinical impression was thought to be deep fungal infection or metastatic carcinoma. Trichophyton rubrum with a dysmorphic morphology simulating blastomycosis was ultimately diagnosed.

Research paper thumbnail of Review of Instructive Cases from the Zola Cooper and Lee T. Nesbitt Seminar

SKIN The Journal of Cutaneous Medicine, 2019

Histopathological examination is considered to be the gold standard for diagnosis. However, resea... more Histopathological examination is considered to be the gold standard for diagnosis. However, research has shown that clinical correlation with pathological examination is crucial for the appropriate diagnosis. This is especially true in dermatology/dermatopathology where several entities can appear similar under the microscope, but are vastly different with their clinical presentation and vice versa. With this in mind, we mention the Zola Cooper- Lee T. Nesbitt Seminar that was established in 1954 and is the longest free standing clinical-pathologic conference still in existence. The purpose of the seminar is to serve as an educational conference designed to promote continuous excellence in the field of clinical dermatology and dermatopathology. Herein, we present six cases that were presented at the conference which highlight the importance of the clinical-pathological correlation in the practice of dermatology.

Research paper thumbnail of Development and Validation of a Diagnostic 35-Gene Expression Profile Test for Ambiguous or Difficult-to-Diagnose Suspicious Pigmented Skin Lesions

SKIN The Journal of Cutaneous Medicine

Purpose: A clinical hurdle for dermatopathology is the accurate diagnosis of melanocytic neoplasm... more Purpose: A clinical hurdle for dermatopathology is the accurate diagnosis of melanocytic neoplasms. While histopathologic assessment is frequently sufficient, high rates of diagnostic discordance are reported. The development and validation of a 35-gene expression profile (35-GEP) test that accurately differentiates benign and malignant pigmented lesions is described. Methods: Lesion samples were reviewed by at least three independent dermatopathologists and included in the study if 2/3 or 3/3 diagnoses were concordant. Diagnostic utility of 76 genes was assessed with quantitative RT-PCR; neural network modeling and cross-validation were utilized for diagnostic gene selection using 200 benign nevi and 216 melanomas for training. To reflect the complex biology of melanocytic neoplasia, the 35-GEP test was developed to include an intermediate-risk zone. Results: Validation of the 35-GEP was performed in an independent set of 273 benign and 230 malignant lesions. The test demonstrated ...

Research paper thumbnail of Sentinel lymph node biopsy as an adjunct to management of histologically difficult to diagnose melanocytic lesions: A proposal

Journal of the American Academy of Dermatology, 2000

Research paper thumbnail of Actinic Keratoses and the Incidence of Occult Squamous Cell Carcinoma: A Clinical?Histopathologic Correlation

Dermatologic Surgery, 2006

BACKGROUND The ability to clinically diagnose actinic keratoses (AKs) lesions has been taken for ... more BACKGROUND The ability to clinically diagnose actinic keratoses (AKs) lesions has been taken for granted for some time. The importance of the malignant potential of these lesions is well known. However, a recent Phase IV, multicenter study assessing the long-term benefit of aminolevulinic acid–based photodynamic therapy provided a unique opportunity to prospectively examine the clinical histopathologic correlation of AKs.OBJECTIVE The objective was to characterize the histopathology of clinically diagnosed AK lesions in the study population.METHODS Punch biopsies of 220 clinically diagnosed untreated AKs were performed at baseline plus 51 lesions unresponsive to treatment (total, 271).RESULTS Clinical diagnosis and histopathologic findings agreed in 91% (246/271) of the lesions biopsied. The balance of the biopsied lesions were: (1) benign changes 4% (11/271) and (2) occult cutaneous malignancy in 5% (14/271) of the cases, 12 squamous cell carcinomas and 2 basal cell carcinomas.CONCLUSIONS In this study, about 1 in 25 clinically diagnosed AK lesions identified by board-certified dermatologist investigator(s) were occult early-stage squamous cell carcinomas on histologic assessment, a fact surmised by the medical community that until now had not been well quantified. These findings should be considered when clinicians decide how to treat and manage AK patients.