Richard J Antaya

Yale University, New Haven, CT, United States

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Publications (41)90.14 Total impact

  • Lucinda S Liu, Daniel Sokoloff, Richard J Antaya
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    ABSTRACT: In recent years, oral propranolol has risen from serendipitous discovery to first-line, albeit off-label, therapy for infantile hemangiomas (IHs). This retrospective study explored the utility of a 24-hour hospitalization for the initiation of propranolol therapy in children with problematic IHs by evaluating the effects of systemic propranolol on hemodynamics and blood sugar levels. Thirty-one children were admitted to the hospital to begin oral propranolol at a dose of 2 mg/kg/per day. Heart rate (HR), blood pressure (BP), and blood glucose (BG) measurements were obtained at baseline and 1 to 3 hours before and after each dose of propranolol. No caregivers reported any adverse effects during the hospitalization. On average, HR decreased by 5 beats per minute (bpm) (p < 0.01) and systolic BP decreased by 4 mmHg (p < 0.01) after propranolol administration. There was no statistically significant change in diastolic BP or BG with propranolol therapy. Over the first three doses of propranolol we saw statistically significant attenuation of the effects of propranolol on HR, with HR approaching baseline values during the hospitalization (p = 0.04). We did not see statistically significant changes in BP over the course of three doses of propranolol. This study suggests that 24-hour hospitalization with hemodynamic monitoring may not be necessary for safe initiation of propranolol therapy in otherwise healthy infants. Parental education on frequent feedings to decrease the chance of hypoglycemia may be as effective as 24-hour hospitalization.
    Pediatric Dermatology 07/2013; · 1.04 Impact Factor
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    ABSTRACT: Capillary malformation-arteriovenous malformation (CM-AVM) syndrome is an autosomal dominant disorder caused by mutations in RASA1. Multifocal, small, round-to-oval, pinkish-to-red cutaneous capillary malformations are seen in more than 90% of people with RASA1 mutations. These RASA1-associated cutaneous capillary malformations (CMs) can accompany internal or cutaneous arteriovenous malformation (AVM) or arteriovenous fistula to constitute CM-AVM syndrome. The cutaneous capillary malformations in CM-AVM syndrome are unusual in that some lesions have high-flow characteristics (according to Doppler or a white halo). We describe the histopathologic and corresponding ultrasound and Doppler findings in a CM from a patient with clinical CM-AVM syndrome and show that an arterial component is not present in the dermis or the most superficial portions of the subcutaneous fat but that there is ultrasound evidence that an AVM resides in the underlying adipose tissue.
    Pediatric Dermatology 07/2013; · 1.04 Impact Factor
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    ABSTRACT: Capillary malformation-arteriovenous malformation syndrome is an autosomal dominant disorder caused by mutations in the RASA1 gene and characterized by multiple small, round to oval capillary malformations with or without arteriovenous malformations. Ateriovenous malformations occur in up to one-third of patients and may involve the brain and spine. Although making the diagnosis is straightforward in some patients, there are other patients for whom diagnostic criteria may be helpful in their evaluation. Here we review the literature regarding capillary malformation-arteriovenous malformation syndrome, propose diagnostic criteria, and discuss the care of patients with this condition.
    Pediatric Dermatology 05/2013; · 1.04 Impact Factor
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    ABSTRACT: Kaposiform hemangioendothelioma (KHE) associated with Kasabach-Merritt phenomenon is a life-threatening vasculopathy. The current mainstay treatment for KHEs is corticosteroids and chemotherapy, but these medications do not work for all patients and carry significant side effects. We report a neonate with a large congenital KHE who responded extremely well to low-dose radiation therapy.
    Pediatric Dermatology 03/2013; · 1.04 Impact Factor
  • Brittany G Craiglow, Christine J Ko, Richard J Antaya
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    ABSTRACT: Hemihyperplasia-multiple lipomatosis syndrome (HHML) is a condition characterized by asymmetric nonprogressive overgrowth, multiple lipomas, and superficial vascular malformations. We present two cases of HHML to enhance the diagnostic acumen of dermatologists and avoid potential misdiagnosis of this rare but probably underrecognized entity. We also provide a brief review of asymmetric overgrowth syndromes, which have overlapping yet distinct clinical manifestations.
    Pediatric Dermatology 03/2013; · 1.04 Impact Factor
  • Brittany G Craiglow, Richard J Antaya
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    ABSTRACT: Infantile hemangiomas (IH), benign vascular neoplasms, are the most common tumors of infancy and childhood. Most IH are medically insignificant; however, a proportion will require treatment because of interference with vital structures, threat of significant disfigurement, ulceration, or bleeding. This article reviews current and potential pharmacotherapeutic approaches to the treatment of IH. While corticosteroids have long been considered the mainstay of medical therapy for IH, several new treatments have recently emerged, the most promising of which is oral propranolol. Topical timolol and imiquimod are additional new therapies that may also prove to be effective, particularly for the treatment of superficial IH.
    Paediatric Drugs 03/2013; · 1.88 Impact Factor
  • Kristina J Liu, Richard J Antaya
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    ABSTRACT: Midchildhood acne has been attributed to a number of causes in the literature, including adrenocortical tumor, hyperandrogenemia due to hypothalamic dysfunction, and contact with greasy topical skin care products. There are only a few case reports of inhaled steroids causing acneiform eruptions, all of which occurred in adults and with symptoms suggesting that the acne resulted from systemic absorption. We present two cases of comedonal and inflammatory midchildhood acne temporally associated with the use of inhaled corticosteroids administered through face masks, implicating a causative relationship between topical steroid exposure and midchildhood acne that does not necessitate systemic absorption.
    Pediatric Dermatology 02/2013; · 1.04 Impact Factor
  • Richard J Antaya
    Seminars in perinatology 02/2013; 37(1):1-2. · 2.33 Impact Factor
  • Journal of the American Academy of Dermatology 12/2012; 67(6):e287-9. · 4.91 Impact Factor
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    ABSTRACT: EN, epidermal nevi; KEN, keratinocytic epidermal nevi; LOH, loss of heterozygosity; MAPK, mitogen-activated protein kinase; NS, nevus sebaceus
    Journal of Investigative Dermatology 10/2012; · 6.19 Impact Factor
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    ABSTRACT:   Epidermolysis bullosa pruriginosa (EBP) is a rare subtype of dystrophic epidermolysis bullosa (DEB) characterized by intense pruritus, nodular or lichenoid lesions, and violaceous linear scarring, most prominently on the extensor extremities. Remarkably, identical mutations in COL7A1, which encodes an anchoring fibril protein present at the dermal-epidermal junction, can cause both DEB and EBP with either autosomal dominant or recessive inheritance. We present one family with both dystrophic and pruriginosa phenotypes of epidermolysis bullosa. The proband is a 19-year-old Caucasian woman who initially presented in childhood with lichenoid papules affecting her extensor limbs and intense pruritus consistent with EBP. Her maternal grandmother saw a dermatologist for similar skin lesions that developed without any known triggers at age 47 and mostly resolved spontaneously after approximately 10 years. The proband's younger brother developed a small crop of pruritic papules on his elbows, dorsal hands, knees, and ankles at age 13. Her second cousin once removed, however, reported a mild blistering disease without pruritus consistent with DEB. Genetic sequencing of the kindred revealed a single dominant novel intron 47 splice site donor G>A mutation, c.4668 + 1 G>A, which we predict leads to exon skipping. Incomplete penetrance is confirmed in her clinically unaffected mother, who carries the same dominant mutation. The wide diversity of clinical phenotypes with one underlying genotype demonstrates that COL7A1 mutations are incompletely penetrant and strongly suggests that other genetic and environmental factors influence clinical presentation.
    Pediatric Dermatology 04/2012; · 1.04 Impact Factor
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    ABSTRACT: Tufted angioma (TA), an uncommon benign vascular tumor, has a variable clinical presentation, and histopathologic findings are a key component of diagnosis. The presence of lymphatic vessels suggestive of lymphangioma can occasionally be the predominant finding and cause diagnostic confusion. Nine biopsies from 7 cases of TA were studied to assess the frequency and distribution of lymphangioma-like areas. Specimens were also stained with D2-40, VEGF-A, GLUT-1, and HHV-8. In one biopsy, lymphangioma-like vessels were the main finding. In all other cases of TA, lymphatics were present in the stroma but were often overshadowed by tufts of capillaries. D2-40 highlighted the stromal lymphatics and partially stained the capillaries within tufts. VEGF-A showed diffuse nonspecific staining of epidermis and endothelial cells in all specimens. GLUT1 and HHV-8 staining were uniformly negative in all 9 specimens. Accurate diagnosis of TA has important clinical implications given its occasional association with Kasabach-Merritt phenomenon, and the presence of lymphangioma-like vessels in biopsies of vascular lesions is entirely compatible with TA.
    The American Journal of dermatopathology 01/2012; 34(4):400-3. · 1.30 Impact Factor
  • Brea Prindaville, Richard J Antaya
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    ABSTRACT:   Microgeodic disease, similar to chilblains (pernio), is characterized by painful, erythematous swelling, as well as small, punched-out erosions found in affected phalanges. Although they share a similar appearance and proposed pathogenesis, chilblains has rarely been diagnosed in children with microgeodic disease, and in those cases has not been confirmed on skin biopsy. This article details a child in Connecticut diagnosed during the winter with chilblains and microgeodic disease of his toe, as supported by biopsy and imaging. These findings further indicate that the two diseases are interrelated, imply a similar pathogenesis, and lead us to suggest similar treatment for problematic forms of both diseases.
    Pediatric Dermatology 01/2012; · 1.04 Impact Factor
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    ABSTRACT: CD123-positive plasmacytoid dendrocytes are prominent in the infiltrate of discoid lupus erythematosus (LE). We hypothesized that these cells would also be present in hypertrophic LE and would aid in the histopathologic distinction from squamous cell carcinoma (SCC) and hypertrophic actinic keratosis (AK). Five cases of hypertrophic LE and 10 cases each of SCC and hypertrophic AK were stained with CD123. A heavy band of CD123-positive cells was present at the epidermal-dermal junction in all cases of hypertrophic LE, and only single or rare scattered clusters of CD123-positive cells were seen in SCC and actinic keratoses. The pattern of CD123 staining can be a useful feature to distinguish hypertrophic LE from SCC and hypertrophic AK.
    Journal of Cutaneous Pathology 11/2011; 38(11):889-92. · 1.77 Impact Factor
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    ABSTRACT: We present two cases of neonates born with symmetric aplasia cutis congenita associated with intrauterine fetal demise of cotwins during the early second trimester. Fetus papyraceus resulting in aplasia cutis congenita is a rare association with many clinical presentations, including extratruncal symmetric lesions and small linear, arcuate, and triangular lesions when twin intrauterine demise occurs after the first trimester.
    Pediatric Dermatology 03/2011; 28(4):467-9. · 1.04 Impact Factor
  • Richard J Antaya, Deanne Mraz Robinson
    Pediatric Annals 10/2010; 39(10):635-45. · 0.30 Impact Factor
  • Jennifer M McNiff, Jinah Kim, Richard J Antaya
    Journal of the American Academy of Dermatology 09/2010; 63(3):e67-8. · 4.91 Impact Factor
  • International journal of dermatology 02/2010; 49(2):189-92. · 1.18 Impact Factor
  • Swapna Reddy, Richard J Antaya
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    ABSTRACT: Two unrelated Hispanic females, ages 4 and 3 years, respectively, each presented with a solitary patch of excessive terminal hair growth in the midline of the neck. This rare form of congenital localized hypertrichosis, known as anterior cervical hypertrichosis, is reported here as an isolated defect with no other underlying abnormalities.
    Pediatric Dermatology 01/2010; 27(5):531-3. · 1.04 Impact Factor
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    ABSTRACT: Adult and pediatric patients (n = 347) with atopic dermatitis enrolled in three multicenter, randomized, 6-week studies who had previously used steroids were analyzed to examine the null hypothesis that improvement in atopic dermatitis initiated after prior treatment with steroids eliminates any subsequent treatment differences between tacrolimus ointment and pimecrolimus cream. Of these patients, 171 were randomized to tacrolimus ointment and 176 to pimecrolimus cream. Based on improvement in the Eczema Area and Severity Index at the end of study, tacrolimus ointment was significantly more effective than pimecrolimus cream (p = 0.0002). Tacrolimus ointment was also significantly more effective than pimecrolimus cream at the end of study in all secondary end-points. Overall, the frequency of adverse events was comparable between treatment groups (24.0% for tacrolimus ointment vs. 25.6% for pimecrolimus cream). Tacrolimus ointment is more effective, with a similar safety profile, compared with pimecrolimus cream in patients with atopic dermatitis previously treated with topical corticosteroids.
    Acta Dermato-Venereologica 01/2010; 90(1):58-64.

Publication Stats

154 Citations
90.14 Total Impact Points


  • 2005–2013
    • Yale University
      • • Department of Dermatology and Pediatric Dermatology
      • • Department of Internal Medicine
      • • Department of Pediatrics
      New Haven, CT, United States
    • Dartmouth Medical School
      • Department of Medicine
      Hanover, NH, United States
  • 2004–2013
    • Yale-New Haven Hospital
      New Haven, Connecticut, United States
  • 2010
    • University of Miami Miller School of Medicine
      Miami, Florida, United States