Laura Y Mcgirt

• MD
• Managing Director at Carolinas Medical Center University

Pruritus may impair quality of life in patients with Sézary syndrome, the leukemic variant of cutaneous T-cell lymphomas. Management of pruritus is challenging and often unsatisfactory. Retrospective reports have found aprepitant, a neurokinin 1 receptor antagonist approved for the treatment of chemotherapy-induced or postoperative emesis, to show...

Skin cancer” is a well-known phrase, common in the lexicon of the general population and often brings to mind diseases such as melanoma and basal cell carcinoma. Although these are of the more commonly encountered skin cancers, the diverse embryological origins of the skin has led to an almost innumerable variety of malignancies. Indeed, skin cance...

Cutaneous T-cell lymphoma (CTCL) is a rare but increasing malignancy whose protean manifestations necessarily present in the integument, but can also spread to involve blood, lymph nodes and internal organs. We have developed efficacious and varied therapies to treat early and advanced stage disease, but there are still many who suffer tremendously...

Lupus miliaris disseminatus faciei (LMDF) is an inflammatory dermatosis characterized by 1- to 3-mm red-to-yellow-brown papules on the central and lateral face, particularly on and around the eyelids. Lesions can occur singly or in crops. The discrete papules appear yellow-brown (“apple-jelly”) on diascopy and as epithelioid cell granulomas histolo...

Background: Cutaneous T-cell lymphomas (CTCL) are skin malignancies including mycosis fungoides (MF) and CD30(+) lymphoproliferative disorders (LPD). In early disease, CTCL can be difficult to diagnose, especially in MF for which there is no reliable diagnostic marker. MF/CTCL have increased expression of thymocyte selection-associated HMG box pro...

The pathogenesis of mycosis fungoides (MF), the most common cutaneous T-cell lymphoma (CTCL), is unknown. Although genetic alterations have been identified, none are considered consistently causative in MF. To identify potential drivers of MF, we performed whole genome sequencing of MF tumors and matched normal skin. Targeted ultra-deep sequencing...

The pathogenesis of the cutaneous T-cell lymphoma (CTCL), mycosis fungoides (MF), is unclear. MicroRNA (miRNA) are small noncoding RNAs that target mRNA leading to reduced mRNA translation. Recently, specific miRNA were shown to be altered in CTCL. We detected significantly reduced expression of miR-223 in early-stage MF skin, and further decreased...

Mycosis fungoides (MF) is a rare, but potentially devastating malignancy. It classically presents with cutaneous patches and plaques and can progress to tumours on the skin with lymph node, blood and visceral involvement. While most patients with MF have a relatively benign disease course, a subset of patients will develop progressive disease that...

Given the fundamental roles of histone deacetylases (HDACs) in the regulation of DNA repair, replication, transcription and chromatin structure, it is fitting that therapies targeting HDAC activities are now being explored as anti-cancer agents. In fact, two histone deacetylase inhibitors (HDIs), SAHA and Depsipeptide, are FDA approved for single-a...

CTCL cell lines exhibit sensitivity to multiple doses of 233 and high dose 136. Dose curves of HH cells (left) or Hut78 cells (right) treated with 10 µM 233 (A) or 966 (B). Cells were treated once with DMSO, 10 nM Depsipeptide (Depsi), or different concentrations of either 233 or 136 at hour 0. Untreated cells and DMSO treated cells were used as co...

HDI treatment after labeling with IdU and CldU shows no changes in DNA fiber length. (A) DNA fiber labeling analysis was used to assess DNA fiber length in Hut78 cells treated with either DMSO, 10 nM Depsipeptide (left) or 10 µM 966 (right) 4 hrs after labeling the cells with IdU for 20 mins (green) followed by 20 mins of CldU (red). (A) Graphical...

CTCL cell lines exhibit additive sensitivity to the combination of 233 and 966. Viability curves of Hut78 cells treated with the indicated amounts of RGFP966 and 233. Cells were treated once with DMSO, 10 nM Depsipeptide (Depsi), or different concentrations of either 233 or 966 at hour 0. Untreated cells and DMSO treated cells were used as controls...

Dose curves for Bexarotene, Methotrexate, and ATRA reveal optimal concentrations for combination treatments. Dose curves of Bexarotene (A), Methotrexate (B), and ATRA (C) treated HH cells or Hut78 cells. Cells were treated at hour 0 with DMSO, 10 nM Depsipeptide (Depsi), or varying concentrations of Bexarotene, Methotrexate, or ATRA. Cell growth wa...

HDIs increased in apoptosis, DNA damage, and cell cycle defects in HH cells. (A) HH cells were treated with DMSO, 10 nM Depsipeptide (Depsi), 10 µM 233, or 10 µM 966 for 24 hr and apoptosis levels were assessed by Annexin V/PI staining and flow cytometry. Untreated (UT) and DMSO treated cells were used as controls. Shown is a representative graph f...

Calciphylaxis is a metastatic calcification-induced vasculopathy that results in the occlusion of small blood vessels. Although calciphylaxis is normally associated with end-stage renal disease, calciphylaxis from non-uremic origin occurs as well. While the number of reports continues to increase, a standard treatment for non-uremic calciphylaxis h...

Atopic dermatitis (AD) is characterized by epidermal tight junction (TJ) defects and a propensity for Staphylococcus aureus skin infections. S. aureus is sensed by many pattern recognition receptors, including Toll-like receptor 2 (TLR2). We hypothesized that an effective innate immune response will include skin barrier repair, and that this respon...

. Eczema herpeticum (EH) is a potentially serious, systemic complication in subjects with atopic dermatitis (AD) caused by herpes simplex virus (HSV). The innate immune dysregulation that predisposes these subjects to cutaneous viral infections is not well understood. We tested the hypothesis that defects in mannan-binding lectin (MBL) may be assoc...

Atopic dermatitis (AD) is characterized by dry skin and a hyperactive immune response to allergens, 2 cardinal features that are caused in part by epidermal barrier defects. Tight junctions (TJs) reside immediately below the stratum corneum and regulate the selective permeability of the paracellular pathway. We evaluated the expression/function of...

Extracorporeal photopheresis (ECP) has been utilized for more than 20 years to treat cutaneous T-cell lymphoma (CTCL), but a clinical response can take up to 9 months to manifest. This study was undertaken to determine whether clinical features, laboratory values, cytokine levels, or gene expression levels of tumor markers are useful to predict the...

Cryptococcus neoformans is a dimorphic fungus known to cause disease predominately in immuno-compromised patients. It is not uncommon for cryptococcal disease to manifest within the cutaneous tissues of these patients, and it can have drastically varied presentations, from ulcerated nodules to a more subtle cellulitis. We present a patient who unde...

Core Messages: Cutaneous lymphomas are malignancies of the skin composed most commonly of aberrant lymphocytes from either a B or T-cell lineage. These lymphomas manifest in heterogenous clinical presentations, including the subtle eczematous patch to the more observable ulcerated nodules and tumors. There is also marked variation in morbidity and...

Gigantomastia is a rare breast condition characterised by diffuse, rapid, and excessive breast hypertrophy that can result in symptoms ranging from pain to necrosis and sepsis. It typically occurs in the setting of marked hormonal changes such as puberty and pregnancy. Rarely, gigantomastia has been reported to develop in the setting of an autoimmu...

Atopic dermatitis (AD) is a common chronic inflammatory skin disease that has increased in prevalence over the last half century. A growing body of evidence suggests that there are a variety of defects in the innate immune system that collectively affect the development and severity of AD. The reduction in antimicrobial peptides, diminished recruit...

Staphylococcal colonization of the skin is commonly observed in subjects with atopic dermatitis (AD) and correlates with disease severity. Little is known about whether the degree of T-helper 2 (Th2) polarity in these subjects can also affect the frequency of bacterial colonization in this disease. To determine if there is a correlation between mar...

Intravascular B-cell lymphoma is a rare type of non-Hodgkin's lymphoma that is characterized by a clonal proliferation of lymphoblasts within small blood vessels. Patients present with nonspecific symptoms and are often only given a diagnosis at autopsy. We report a case of intravascular B-cell lymphoma, characterized by pyrexia, anemia, thrombocyt...

Antihistamines are the standard treatment for chronic idiopathic urticaria (CIU). For patients whose urticaria is unresponsive to antihistamines, the treatment options are limited. During the previous decade, there have been several case reports demonstrating success with sulfasalazine therapy. In this article, we present a case series evaluating s...

Atopic dermatitis (AD) is a common, chronic inflammatory skin disease that becomes clinically apparent in the pediatric population. It is well recognized that subjects with AD have an increased susceptibility to cutaneous colonization and infection with bacteria, fungi, and viruses. The notion that subjects with AD have a cutaneous immune defect ha...

Widespread introduction of highly active antiretroviral therapy (HAART) in the mid 1990s has altered the presentation of the cutaneous manifestations associated with HIV infection. Our purpose was to evaluate the use of HAART on the prevalence and spectrum of cutaneous manifestations in HIV-infected patients. A study of the initial visits of 897 HI...

Perianal dermatosis can encompass lesions from benign eczematous processes to advanced malignancies. It is important for the colorectal surgeon to be able to distinguish common problems from more serious pathology. This article covers nonsexually transmitted diseases occurring in the intergluteal fold and perianal region. These include inflammatory...

Candida lusitaniae is an emerging human pathogen that, unlike other fungal pathogens, frequently develops resistance to the commonly used antifungal agent amphotericin B. Amphotericin B is a member of the polyene class of antifungal drugs, which impair fungal cell membrane integrity. Here we analyzed mechanisms contributing to amphotericin B resist...

The identification of patients at an increased risk for cerebral vasospasm after subarachnoid hemorrhage (SAH) may allow for more aggressive treatment and improved patient outcomes. Note, however, that blood clot size on admission remains the only factor consistently demonstrated to increase the risk of cerebral vasospasm after SAH. The goal of thi...

Candida lusitaniae is a dimorphic yeast that is emerging as an opportunistic fungal pathogen. In contrast to Candida albicans, which is diploid and asexual, C. lusitaniae has been reported to have a sexual cycle. We have employed genetic approaches to demonstrate that C. lusitaniae is haploid and has a sexual cycle involving mating between MATa and...