David Peng

University of Southern California, Los Angeles, CA, United States

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Publications (21)50.49 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background/Aims In contrast to declines in the incidence of most common cancers, melanoma continues to rise with 76,250 new cases and over 9,000 deaths in the US in 2012. While melanoma detected at early stage has an excellent prognosis, most Americans do not know skin cancer signs. Population-based physician-initiated screening has proved impractical. Self-skin examination (SSE) has the potential to ameliorate the harm from melanoma in a feasible, cost-effective way. The limited studies of SSE to date were conducted mostly among patients receiving dermatology-specialty care. Methods To test the acceptability and sensitivity/specificity of a SSE toolkit, we recruited subjects from the general membership of Kaiser Permanente Southern California, an integrated health plan serving a geographic area with one of the highest melanoma risks in the world. Potential non-Hispanic white subjects 22-50 years old without a history of cancer were offered the opportunity to compare their assessments of their nevi with clinical evidence from full body skin exams and digital imaging. Results Forty percent of those reached by phone (493/1228) agreed to participate. Acceptors were more likely to be female (74% vs. 57%, P <.001), but no differences were found by age (mean age = 39 years), education (44% high school or less), or income (34% annual household less than $50,000). Few and only small differences in participation were found for diagnoses of overweight or obesity, hypertension, hyperlipidemia, or depression; and co-morbidity score or health care utilization including dermatology services. Participants were more likely to have had a flu shot (47% vs. 39%, P <.001) and to be a never smoker (71% vs. 65%, P = .05). As expected in this general patient population, fewer than 10% of those contacted had a clinical skin exam in the previous 3 years (8% of participants vs. 2% of non-participants P <.001). Conclusions Self-skin examination appears to be of interest to a large proportion of adults contacted by the study, especially women. Few meaningful differences in participation were found. Modestly higher flu vaccination and lower never smoking may indicate a stronger health orientation among participants.
    Clinical Medicine &amp Research 09/2013; 11(3):126.
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    ABSTRACT: Background  (i) To assess the baseline knowledge of non-medical skin care professionals (estheticians, cosmetologists, massage therapists) on tanning bed use and its association with melanoma; and (ii) to provide preliminary evidence of the potential impact of a fast and simple educational intervention on tanning beds and melanoma on the awareness of non-medical skin care professionals towards skin cancer prevention. Methods  A pre-intervention survey was administered to non-medical skin care professional at salons or spas in Southern California to assess baseline knowledge on tanning and skin cancer. This was followed immediately by a 10-minute oral presentation on tanning bed use and its association with melanoma. One month later, a post-intervention survey was distributed to individuals who attended the initial oral presentation. Results  Significant changes pre- and post-intervention were found in non-medical skin care professionals' answer responses to the following: (i) increased speaking to clients about cancer risk with tanning bed use 42-66% (OR 2.44; 95% CI 1.39, 4.30)]; (ii) decreased personal tanning bed use (23-15% [OR 0.61; 95% CI 0.37, 1.00]); and (iii) decreased belief that tanning beds are an excellent cosmetic tool (29-20% [OR 0.60; 95% CI 0.38, 0.96]). Conclusion  This study provides preliminary evidence that non-medical skin care professionals could be an important source of primary prevention information for reducing the burden of melanoma.
    International journal of dermatology 11/2012; 51(11):1307-12. · 1.18 Impact Factor
  • Andrea L Tichy, David H Peng, Alfred T Lane
    Journal of the American Academy of Dermatology 04/2012; 66(4):696-7. · 4.91 Impact Factor
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    ABSTRACT: Our group's 2009 study of the integrity of the dermatology match revealed that some dermatology program directors violated National Resident Matching Program (NRMP) policy during their communications with applicants. Our group's article concluded with recommendations to change this behavior. We repeated a survey of dermatology applicants to understand if dermatology program personnel behavior has changed since our group's 2009 study of the dermatology match. We surveyed 2011 applicants to Department of Dermatology, Stanford University, Palo Alto, CA. The survey was anonymous and available online. Of applicants, 14% were asked to reveal how they intended to rank a program before match day. Of applicants, 32% felt pressured to reveal how they intended to rank programs. Of applicants, 90% were asked about interviews at other programs. Of applicants, 44% were asked about their marital status and 19% were asked if they had children or intended to have children. The response rate for applicants was 53%. Although our previous study increased knowledge about the problems within the dermatology match, dermatology program personnel continue to violate NRMP policy. The most widespread violations are asking applicants where they will interview, asking applicants if they are married, and pressuring applicants to reveal how they intend to rank programs. We continue to recommend that programs avoid postinterview contact, and recommend that the NRMP create training videos for applicants and interviewers.
    Journal of the American Academy of Dermatology 11/2011; 67(3):429-35. · 4.91 Impact Factor
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    ABSTRACT: We established the most common cutaneous diseases that received dermatology consultation in the adult emergency department (ED) and identified differentiating clinical characteristics of dermatoses that required hospital admission. A retrospective chart review of 204 patients presenting to the ED who received dermatology consultations at Los Angeles County/University of Southern California Medical Center, an urban tertiary care teaching hospital. Of all patients, 18% were admitted to an inpatient unit primarily for their cutaneous disease, whereas 82% were not. Of nonadmitted patients, the most commonly diagnosed conditions were eczematous dermatitis not otherwise specified (8.9%), scabies (7.2%), contact dermatitis (6.6%), cutaneous drug eruption (6.0%), psoriasis vulgaris (4.2%), and basal cell carcinoma (3.6%). Of patients admitted for their dermatoses, the most highly prevalent conditions were erythema multiforme major/Stevens-Johnson syndrome (22%), pemphigus vulgaris (14%), and severe cutaneous drug eruption (11%). When compared with those of nonadmitted patients, admitted skin conditions were more likely to be generalized (92% vs 72%; P = 0.0104), acute in onset (<1 month duration) (81% vs 51%; P = 0.0005), painful (41% vs 15%; P = 0.0009), blistering (41% vs 7.8%; P < 0.0001), and ulcerated or eroded (46% vs 7.8%; P < 0.0001). They were more likely to involve the mucosa (54% vs 7.2%; P < 0.0001) and less likely to be pruritic (35% vs 58%; P = 0.0169). We have described a cohort of patients receiving dermatologic consultation in the ED of a large urban teaching hospital. These data identify high-risk features of more severe skin disease and may be used to refine curricula in both emergency and nonemergency cutaneous disorders for emergency physicians.
    The western journal of emergency medicine 11/2011; 12(4):551-5.
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    ABSTRACT: Pancreatic panniculitis represents a rare cutaneous disorder most commonly associated with acute or chronic pancreatitis or pancreatic carcinoma. We describe a case of a 17-year-old woman who presented with a 2-day history of erythematous patches involving her bilateral knees and tender, scattered red-brown nodules involving her bilateral anterior shins. She was seen during a hospitalization for emergent cesarean section and her hospital course was complicated by HELLP syndrome (defined by the presence of hemolysis, elevated liver enzymes, low platelet count), acute fatty liver of pregnancy and pancreatitis. The characteristic histopathologic findings, including ghost cells, fat necrosis and granular basophilic material with dystrophic calcification, appear in later lesions. In early lesions, as was shown in this case, a neutrophilic subcutaneous infiltrate raises a differential diagnosis including infection, subcutaneous Sweet's syndrome or atypical erythema nodosum. To our knowledge, this represents the first report of pancreatic panniculitis in association with HELLP syndrome and acute fatty liver of pregnancy. Early recognition is critical, as skin lesions may precede the development of pancreatitis. Often, as in our case, the effects of pancreatitis may be life threatening.
    Journal of Cutaneous Pathology 07/2011; 38(10):814-7. · 1.77 Impact Factor
  • Angie T Ng, David H Peng
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    ABSTRACT: Calciphylaxis is a disease in which metastatic calcification affects small- and medium-sized vessels resulting in significant dermatologic manifestations. Lesions typically occur over areas of high fat content and progress to black leathery eschars. Calciphylaxis is associated with intense pain and markedly increased risk of infection, often leading to sepsis requiring hospitalization. Diagnosis is made by clinical history and skin biopsy. Management of calciphylaxis is interdisciplinary, emphasizing factors such as primary prevention, proper wound care, pain control, and hormone and mineral balance. Although calciphylaxis carries a high mortality rate, symptomatic treatment has shown promise as a method for controlling disease progression.
    Dermatologic Therapy 03/2011; 24(2):256-62. · 1.96 Impact Factor
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    ABSTRACT: The incidence patterns and socioeconomic distribution of cutaneous melanoma among Hispanics are poorly understood. The authors obtained population-based incidence data for all Hispanic and non-Hispanic white (NHW) patients who were diagnosed with invasive cutaneous melanoma from 1988 to 2007 in California. By using a neighborhood-level measure of socioeconomic status (SES), the variables investigated included incidence, thickness at diagnosis, histologic subtype, anatomic site, and the relative risk (RR) for thicker (>2 mm) versus thinner (≤ 2 mm) tumors at diagnosis for groups categorized by SES. Age-adjusted melanoma incidence rates per million were higher in NHWs (P < .0001), and tumor thickness at diagnosis was greater in Hispanics (P < .0001). Sixty-one percent of melanomas in NHWs occurred in the High SES group. Among Hispanics, only 35% occurred in the High SES group; and 22% occurred in the Low SES group. Lower SES was associated with thicker tumors (P < .0001); this association was stronger in Hispanics. The RR of thicker tumors versus thinner tumors (≤ 2 mm) in the Low SES group versus the High SES group was 1.48 (95% confidence interval [CI], 1.37-1.61) for NHW men and 2.18 (95% CI, 1.73-2.74) for Hispanic men. Patients with lower SES had less of the superficial spreading melanoma subtype (especially among Hispanic men) and more of the nodular melanoma subtype. Leg/hip melanomas were associated with higher SES in NHW men but with lower SES in Hispanic men. The socioeconomic distribution of melanoma incidence and tumor thickness differed substantially between Hispanic and NHW Californians, particularly among men. Melanoma prevention efforts targeted to lower SES Hispanics and increased physician awareness of melanoma patterns among Hispanics are needed.
    Cancer 01/2011; 117(1):152-61. · 5.20 Impact Factor
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    ABSTRACT: Xanthoma disseminatum (XD) is a rare normolipemic histiocytic disorder of non-Langerhans cell origin characterized by erythematous to tan/brown papules in flexor surfaces. Considered a generally benign, chronic disease of unknown etiology, XD typically affects the skin, mucous membranes, and less commonly, other organs. To date, there has been no typical or consistent inheritance pattern described, nor has it ever been considered as a component of any known syndrome. We describe, for the first time, two cases of XD in a pair of blind and deaf twin brothers.
    ISRN dermatology. 01/2011; 2011:342909.
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    ABSTRACT: Visible skin disorders can limit healthy psychosocial development in several domains owing to the stigma these disorders create. To assess if emerging adults with acne and eczema perceive stigma in diverse developmental domains resulting from their visible skin conditions. A convenience sample of 336 emerging adults attending a diverse public university in northern California completed a Web-based survey. Multivariate modeling was used to determine if eczema and acne result in perceived stigma. The mean (SD) age of respondents was 20.1(1.5) years; most were white (43.2%) and female (62.5%). Almost half (47%) reported acne and 16.4% reported eczema. The likelihood of experiencing perceived stigma was 1.6 (95% CI 1.13-2.27, p < .001) times higher for those with eczema compared to those without eczema, and the likelihood of experiencing perceived stigma was 3.19 (95% CI 2.41-4.22, p < .0001) times higher for those with acne compared to those without acne. Our findings indicate that emerging adults perceive stigma as a result of their acne and eczema in several important developmental domains. The results suggest that acne may have a stronger relationship with perceived stigma than eczema, perhaps owing to its greater visibility on the body. University-based activities are recommended to support those with skin disease.
    Journal of Cutaneous Maedicine and Surgery 12/2010; 14(6):285-90. · 0.78 Impact Factor
  • Talley B Whang, Lina Wang, David H Peng
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    ABSTRACT: Sister Mary Joseph nodule is a metastatic lesion of the umbilicus, which is an uncommon phenomenon that carries an ominous prognosis. We describe a patient with gastric cancer who presented with asymptomatic papules on the umbilicus proven to be metastatic foci by biopsy. The lesion represented spread of the malignancy despite chemotherapy; thus, treatment was initiated with second-line agents. Sister Mary Joseph nodule can be the first presenting sign of an occult malignancy, or as demonstrated in this case, a sign of disease progression. Given the variable appearance of the lesions, a high index of suspicion is necessary to make an accurate diagnosis.
    Cutis; cutaneous medicine for the practitioner 02/2010; 85(2):90-2. · 0.82 Impact Factor
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    ABSTRACT: The National Cancer Institute's "Melanoma Action Plan" calls for reduction of melanoma mortality through early detection. Routine skin self-examination (SSE) has the potential to increase chances of early detection and treatment and may be the key to melanoma survival. We provide a focused review of the accuracy of SSE for detecting premalignant lesions and cutaneous risk factors for melanoma, with suggestions for future directions for enhancing measurement of SSE accuracy and ways in which to improve the public's perceptions of melanoma efficacy. We examined published data on the efficacy of skin self-examination for the early detection of melanoma. We searched the MEDLINE database for publications between January 1, 1987 and June 1, 2007 using search terms for "melanoma" and "self-examination." We found that sensitivity of skin self-examination is low, ranging from 25% to 93%, while specificity is generally higher (83% to 97%). Attempts to increase improve the lay public's perceptions of the early signs of melanoma have proved effective, while those aimed at increasing accuracy of SSE with targeted interventions have been moderately successful. SSE's insensitivity for detection of pigmented lesions should prompt further investigation of educational interventions to enhance its accuracy and lead to its adoption as a cheap, simple screening tool. Assessment of the accuracy and efficacy of SSE should proceed using standardized definitions and measurements such that it is easier to pool data on the overall value of SSE as a screening modality.
    International journal of dermatology 02/2010; 49(2):126-34. · 1.18 Impact Factor
  • Journal of the American Academy of Dermatology 01/2010; 62(1):154-5. · 4.91 Impact Factor
  • Journal of the American Academy of Dermatology 10/2009; 61(4):728-30. · 4.91 Impact Factor
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    ABSTRACT: The resources used by the public to locate health information are important. To expose the sources from which the public gains a knowledge of dermatology. An anonymous, multiple-choice questionnaire was distributed to adults in college campuses, shopping malls, and community parks over a 4-month period. Sixty-six percent of individuals stated that they felt physicians had the most authority for making recommendations regarding the skin. When questioned about the sources of skin care advice, however, there was a discrepancy, with only 35% stating that they actually consulted professionals. Indeed, 37% admitted to using family and friends as their primary source of information, and 28% used the media first. In our opinion, the best method to ensure healthy skin habits and early diagnosis of disease would be to combine the efforts of healthcare and the media. These public resources should make people aware of skin diseases and preventative measures, whilst encouraging regular check-ups with dermatologists and persuading patients to employ open conversation with their physicians regarding care of their skin.
    International journal of dermatology 06/2009; 48(5):506-12. · 1.18 Impact Factor
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    Journal of the American Academy of Dermatology 01/2009; 59(6):1081-5. · 4.91 Impact Factor
  • International journal of dermatology 11/2008; 47(10):993-1003. · 1.18 Impact Factor
  • Archives of dermatology 07/2008; 144(6):795-800. · 4.76 Impact Factor
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    ABSTRACT: As our understanding of the role of UV in causing skin cancer continues to expand, researchers and clinicians must continue to remain up to date on the various means by which UV exposure can be quantified. The purpose of this article was to review the current methods used to measure lifetime exposure to UV and to summarize the strengths and weaknesses of each of these approaches. Thus we include here a review of research articles that deal with questionnaire reliability and physical examination. We also review more technologically advanced techniques used to measure chronic UV exposure; these include microtopography, histology, gene studies and spectroscopy. Both the utility of using a specific measurement technique and the accuracy of particular techniques are explored. Finally, we touch upon the results of articles that link UV exposure to skin cancer and what this means for the future of UV-induced skin cancer research.
    Photochemistry and Photobiology 06/2008; 84(6):1462-72. · 2.29 Impact Factor
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    ABSTRACT: Carcinosarcomas are rare but aggressive neoplasms commonly described in organs such as the breast, urinary bladder, uterus, liver, and lungs. Histopathologically, they are characterized by the presence of malignant epithelial and mesenchymal components. The exact histogenesis of carcinosarcomas remains unknown and is debated in the literature. Primary carcinosarcomas of the skin are uncommon. To our knowledge, 20 cases of primary cutaneous carcinosarcoma have been described in the world literature. Most of these tumors were seen on the head and neck region of older individuals, both male and female. Microscopically, the more common carcinoma component is a squamous cell carcinoma followed by basal cell carcinoma, whereas the most common sarcoma component is an osteosarcoma. We report an example of this rare entity and speculate on its histogenesis in the skin.
    Annals of clinical and laboratory science 02/2005; 35(2):189-94. · 0.88 Impact Factor

Publication Stats

94 Citations
50.49 Total Impact Points

Institutions

  • 2008–2012
    • University of Southern California
      • • Department of Preventive Medicine
      • • Department of Dermatology
      • • Keck School of Medicine
      Los Angeles, CA, United States
  • 2011
    • Stanford Medicine
      • Department of Dermatology
      Stanford, California, United States
    • Stanford University
      • Department of Dermatology
      Stanford, CA, United States
  • 2008–2009
    • Keck School of Medicine USC
      Los Angeles, California, United States