David H Peng

Stanford University, Palo Alto, California, United States

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Publications (16)37.99 Total impact

  • No preview · Article · Mar 2015 · Radiographics
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    ABSTRACT: There are a variety of conditions that manifest not only in bone but also in skin. Bone and skin structures can share common embryologic origins, and genetic defects that occur early in cell differentiation may lead to disease in both organ systems. Alternatively, diseases of bone and skin may be caused by defects in genes that participate in directing or controlling both systems. Many diseases of bone and skin can manifest with atypical radiologic findings or mimic malignant bone lesions. Upon encountering such a disease process, a radiologist who is familiar with both aspects of the disorder and consequently looks for associated skin findings can greatly benefit the patient by making a definitive diagnosis. Similarly, a clinician who encounters suggestive skin lesions should be prompted to look for concomitant skeletal lesions. By synthesizing knowledge of bone and skin manifestations, radiologists and clinicians can help correctly diagnose a number of these disease processes, thereby helping patients avoid further, often nonspecific invasive workup and advancing patient care. © RSNA, 2014.
    Preview · Article · Jan 2014 · Radiographics
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    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.
    No preview · Article · Sep 2013 · Clinical Medicine & Research
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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.
    No preview · Article · Nov 2012 · International journal of dermatology
  • Andrea L Tichy · David H Peng · Alfred T Lane

    No preview · Article · Apr 2012 · Journal of the American Academy of Dermatology
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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.
    No preview · Article · Nov 2011 · Journal of the American Academy of Dermatology
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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.
    Full-text · Article · Nov 2011 · The western journal of emergency medicine
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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. Kirkland EB, Sachdev R, Kim J, Peng D. Early pancreatic panniculitis associated with HELLP syndrome and acute fatty liver of pregnancy.
    No preview · Article · Jul 2011 · Journal of Cutaneous Pathology
  • 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.
    No preview · Article · Mar 2011 · Dermatologic Therapy
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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.
    Full-text · Article · Jan 2011 · Cancer
  • Reyhaneh Hamidi · David Peng · Myles Cockburn
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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.
    No preview · Article · Feb 2010 · International journal of dermatology
  • 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.
    No preview · Article · Feb 2010 · Cutis; cutaneous medicine for the practitioner

  • No preview · Article · Oct 2009 · Journal of the American Academy of Dermatology
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    Full-text · Article · Jan 2009 · Journal of the American Academy of Dermatology
  • Reyhaneh Hamidi · Myles G Cockburn · David H Peng

    No preview · Article · Nov 2008 · International journal of dermatology
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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.
    No preview · Article · Jun 2008 · Photochemistry and Photobiology

Publication Stats

171 Citations
37.99 Total Impact Points


  • 2011-2015
    • Stanford University
      • Department of Dermatology
      Palo Alto, California, United States
  • 2009-2011
    • University of Southern California
      • • Department of Preventive Medicine
      • • Department of Dermatology
      Los Angeles, California, United States
    • VA Palo Alto Health Care System
      Palo Alto, California, United States
  • 2010
    • University of California, Los Angeles
      Los Ángeles, California, United States
  • 2008
    • Keck School of Medicine USC
      Los Angeles, California, United States