Andrea D. Maderal’s research while affiliated with University of Miami and other places

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Publications (69)


Need for Consideration of Patient-Specific Risk Factors in Step Therapy
  • Article

March 2025

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1 Read

JAMA Dermatology

Andrea D. Maderal



Clinical features of paraneoplastic pemphigus on physical exam. A, Stomatitis involving the lateral and inferior tongue. B, Eroded papules and plaques affecting the buccal mucosa
Histologic findings of oral mucosa. A and B, The oral mucosa showed lichenoid dermatitis and intraepidermal acantholytic blisters. C, H&E sections (400x) show an ulcerated mucosa with underlying lymphocyte rich infiltrate. D, Direct immunofluorescence (400x) shows intercellular, “chicken wire” deposition of IgG
Lichenoid paraneoplastic pemphigus in a patient presenting with follicular lymphoma: a review of the literature
  • Literature Review
  • Publisher preview available

November 2024

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23 Reads

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1 Citation

Archives of Dermatological Research

Kimberly N. Williams

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Clara Milikowski

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Xiaoqiong Wang

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[...]

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Andrea D. Maderal

Paraneoplastic pemphigus (PNP) is a rare, autoimmune, mucocutaneous blistering disease that is almost always associated with a confirmed or occult neoplasm. PNP often presents with characteristic features of intractable stomatitis and polymorphous cutaneous eruptions, including blisters and lichenoid dermatitis caused by humoral and cell-mediated autoimmune reactions. We present the following case of a patient with follicular lymphoma (FL) who developed lichenoid PNP involving the buccal mucosa and lateral tongue. We also summarize the literature, discussing current proposed mechanisms, guidelines, and treatment of this unique disease. While patients can achieve complete remission from their underlying neoplasm, most patients with PNP do not have a good survival time with a 5-year survival rate of only 38%. This case sheds light on an uncommon occurrence, highlights the need for further studies around PNP as it relates to FL, and suggests that T cell immunosuppressive therapy may be effective in treating FL patients with PNP.

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Citations (41)


... PNP is a form of pemphigus that develops in association with tumors, representing approximately 5% of all pemphigus cases, while PNP is more commonly linked with lymphoma, especially non-Hodgkin lymphomas, and is rarely reported in association with pheochromocytoma. This condition predominantly manifests in adults between 45 and 70 years of age, with relatively equal sex distribution (13 cases in males vs. 14 cases in females) [6][7][8]. This report presents the case of a 62-year-old male patient diagnosed with PNP, which manifests as a rare dermatological disorder. ...

Reference:

Paraneoplastic Pemphigus in a Patient With Pheochromocytoma: A Report of a Rare Case
Lichenoid paraneoplastic pemphigus in a patient presenting with follicular lymphoma: a review of the literature

Archives of Dermatological Research

... For patients with TEN, the median time to onset was 4.0 weeks and the average time was 11.3 weeks. Several cases of TEN after termination of treatment have also been previously reported (3). Various possible mechanisms have been described to explain the induction of SJS/TEN in patients treated with ICIs. ...

Immune checkpoint inhibitor associated epidermal necrosis, beyond SJS and TEN: a review of 98 cases

Archives of Dermatological Research

... External factors such as exposure to pollutants, nutritional deficiencies, and chronic stress have been linked to hair loss. Environmental pollutants may trigger inflammatory cascades that adversely affect scalp health [40]. Nutritional inadequacies, particularly deficits in proteins, vitamins, and minerals, can compromise the structural integrity of hair fibers [41,47]. ...

The Effects of Environmental Pollutants and Exposures on Hair Follicle Pathophysiology
  • Citing Article
  • April 2024

Skin Appendage Disorders

... While they play a crucial role in ensuring the sterility and efficacy of pharmaceuticals, many preservatives have received increased scrutiny in recent years due to unforeseen side effects. For example, parabens such as methylparaben and propylparaben have raised concerns over potential long-term health risks [1]. For instance, studies on parabens have shown that they may exhibit estrogenic activity, leading to concerns about their potential to disrupt hormonal balance in both men and women [2]. ...

Toxic Ingredients in Personal Care Products: A Dermatological Perspective
  • Citing Article
  • December 2023

Dermatitis

... The second factor, which was the term MII, refers to relatively mild physical discomfort, tenderness, or soreness that usually does not require extensive medical considerations [47][48][49]. The MII pain can be considered to some extent as dysesthesia, an abnormal or unpleasant sensation experienced by an individual [50]. Unpleasant sensations related to superficial minor cuts, burns, or bruises, along with mild itching, sprains, redness, or swelling are considered the most common MII [51,52]. ...

Approach to Diagnosis, Evaluation, and Treatment of Generalized and Non-Local Dysesthesia: A review
  • Citing Article
  • July 2023

Journal of the American Academy of Dermatology

... However, the historical nature of this study limits our ability to fully assess all the factors that might have influenced the treatment decision such as patient or parental preferences, adherence factors, insurance delays, presence of axial disease, or presence of extra-articular manifestation of disease activity (eg, uveitis). 33 Regarding the study population, MSUS examinations were not routinely or regularly performed for all polyarticular JIA patients at our center. This approach might limit the generalizability of our study findings. ...

Insurance delays in the approval of biologic medications for patients with psoriasis and psoriatic arthritis
  • Citing Article
  • November 2022

Archives of Dermatological Research

... Consequently, improper delivery of immunotherapies can result in imbalance of the complicated immune system and ensuing adverse events, sometimes may be life-threatening. For example, the improper administration of steroids or immunosuppressants in autoimmune diseases or organ recipients could result in severe infection or malignancies (127)(128)(129). Similarly, attempts to boost anti-cancer immune reaction using immune checkpoint inhibitors may lead to immune-related adverse events (irAEs) resembling autoimmune diseases (130). ...

Malignancy Risk of Non-Biologic Immunosuppressive Therapies: A Review of the Literature with Evidence-Based Treatment Recommendations
  • Citing Article
  • July 2022

... Despite rarely leading to fatality, they can give rise to serious illnesses like condylomata acuminata, a very usual and highly contagious infection that can affect sexual life. 32 Papillomavirus fragments have a common unenveloped icosahedral formation (50−60 nm in diameter), and its genome contains a double-stranded loop (episome) of approximately 8000 base pairs, containing 8 or 9 ORFs. Although the number of genes are limited and has a small genome size, the amount of ciphered proteins is much higher because gene expression requires various promoters and composite splicing patterns. ...

Condyloma acuminata
  • Citing Chapter
  • January 2018

... In terms of vitamins, cardiologists indicated that their patients often ask about vitamin E, dermatologists about vitamins E and D, and orthopedists cite vitamin D as the one their patients seek most (Dickinson et al. 2011). In dermatology, vitamins B3 and B7 are also frequently prescribed (Hadeler and Maderal 2021;Waqas et al. 2020). Regarding the latter, it is worth mentioning the study by Waqas et al. (2020), in which biotin recommendation practices by USA clinics and their knowledge about the interference of this vitamin in laboratory tests were evaluated. ...

Drug interactions of natural supplements in dermatology: a review
  • Citing Article
  • December 2020

International Journal of Dermatology

... A balance between social acceptance of a dermatologic disease, while maintaining patient education on the importance of timely treatment, may be in the best interest of patients. 21 Acne vulgaris is far more common in adolescence, a period of intense physical and psychosocial changes and adolescents have a higher sensitivity to questions related to the appearance, due to the importance they have for social integration. Thus, acne correlated with self-esteem and feelings of shame, as well as stigmatization and subsequent poorer QoL. ...

Acne, the new trend? A discussion of the emerging social movement to embrace acne vulgaris
  • Citing Article
  • June 2020

International Journal of Dermatology