The UTMB Department of Dermatology requires that each resident complete a scholarly project during their residency.
C. Helen Malone, MD
Mohs Reconstruction Surgical Education Activity
Surgical reconstruction after Mohs surgery is in essence the art of filling holes. There are many guiding principles but few strict absolutes and often several reasonable solutions for the same defect. One must take into account patient factors such as medical comorbidities and willingess to undergo multiple procedures to achieve a superior cosmetic result or preference for a minimalist aproach. Additional factors include local tissue mobility, respecting cosmetic subunits, preserving free margins and camouflaging scars. Residents and fellows must learn to assimilate and apply the principles of reconstruction in addition to mastering a precise knowledge of local anatomy, soft tissue handling and suturing techniques. Understandably, many residents and fellows find planning and implementing surgical reconstructions to be a daunting task. Traditional teaching based on observation and didactic lectures are not effective in these circumstances. We designed an active, problem-based educational activity as part of our institution's Mohs micrographic surgery rotation with the goal of improving a resident's ability to plan surgical reconstructions for Mohs surgery patients. Dermatology and Plastic Surgery residents planned sugical repairs on preoperative pictures for patients that they would operate on during their Mohs rotation. The Mohs surgeon provided feedback on the resident's planned repairs during reconstruction planning on the day of the patient's surgery. The residents were given the option to design repairs on printed pictures or to use an iPad application decribed by DuPont et al. at the American College of Mohs Surgery meeting in May of 2015. Voluntary pre and post rotation surveys showed a trend toward improved surgical planning ability, but the reusts did not achieve statistical significance. The Mohs surgical Education Actitivy was well received by our residents and is a valuable addition to our institution's Mohs micrographic surgery rotation.
Faculty mentor: Richard F. Wagner, Jr., MD, JD
Rebecca C. Philips, MD
Cutaneous Nontuberculous Mycobacterial Infections: A Retrospective Study
A 7-year retrospective chart review of atypical mycobacterial infections at UTMB, with examination of the clinical features, histopathology, suceptibility profile and management of each infection.
Faculty mentor: Brent C. Kelly, MD
Janice M. Wilson, MD
Nephrogenic Systemic Fibrosis: A Retrospective Study
A 15-year retrospective study of patients diagnosed withnephrogenic systemic fibrosis at a single tertiary care center. Statistically significan results indicate that patients whose renal function improved after resolution of acute kidney injury or after successful renal transplation experienced cliincal improvement of NSF, while those whose renal function remained impaired did not.
Faulty mentor: Brent C. Kelly, MD
Emily C. Grimshaw, MD
Effectiveness of Different Rituximab Dosing Schedules in Clearance of Pemphigus Vulgaris
A case series of pemphigus vulgaris patients at UTMB treated with rituximab infusion examining different dosing regimens as well as diesase response and side effects.
Faculty mentor: Michael G. Wilkerson, MD
Alison C. Lowe, MD
Multimedia Management of Acne in Adolescent Patients
The primary objective of this study is to evaluate physician percieved compliance with acne treatment regimen among adolescent patients before and after implementation of written and video-based patient instructions.
Faculty mentor: Bernard R. Gibson, MD
Young T. McMahan, MD
A Novel Training Exercise for Learning Digital Nerve Blocks, Nail Avulsions, Matricectomy and Matrix Biopsies in Dermatology Residency
The purpose of this study is to evaluate exposure to nail procedures (which is defined as digital nerve blocks, nail avulsions, nail matricectomy and nail matrix biopsies), knowledge of nail procedures, and confidence in nail procedures among dermatology residents before and after partaking in a novel surgical training workshop to see if there are any statistically significant differences between these groups. Secondary endpoints include evaluating whether the learning objectives were met during the workshop, whether or not residents are likely to use these nail procedures in the future, whether or not biopsy of the matrix is accurate and whether the workshop was a good educational experience.
Faculty Mentor: Bernard R. Gibson, MD
MRSA Colonization Rates Among UTMB Dermatology Healthcare Workers
Staphylococcus Aureus infection is an increasing challenge in medical care, causing well-documented morbidity and mortality. The association of colonization and infection is well outlined in the literature, and approximately 2.3 million people are colonized with methicillin-resistant S. aureus in the United States. Colonized healthcare workers have been associated with S. aureus outbreaks in the community and hospital setting. Furthermore, asymptomatic colonized healthcare workers are capable of transmitting S. aureus to others, causing concern for potential colonization. S. aureus is the most common etiologic agent of skin and soft tissue infections. However, to date, no study has evaluated Staphylococcus Aureus carriage rate in dermatologists. The purpose of our study is to assess the prevalence of methicillin-sensitive S. aureus and methicillin-resistant S. aureus in dermatology staff including faculty, residents, physician assistants, nurses, and medical assistants at our institution. Furthermore, we will investigate how this compares with the known carriage rate amongst general healthcare workers as well as amongst dermatology patients.
Faculty Mentor: Alma C. Berlingeri-Ramos, MD
Lindy S. Ross, MD
Clinical implications of Immunohistochemistry in Sebaceous Neoplasms Suggestive of Muir Torre Syndrome
A retrospective case series of all the cases of biopsy proven sebaceous neoplasm (sebaceous adenoma, sebaceoma, sebaceous carcinoma, and BCC with sebaceous differentiation) at UTMB from 2008 to present. Immunohistochemistry will be reviewed for all cases of sebaceous neoplasms. Patient's with sebaceous neoplasms will have chart review done to see if they meet diagnostic criteria for Muir Torre syndrome and then to see what was done clinically after they were diagnosed with a sebaceous neoplasm. This study aims to further understand what the implications of reflexive immunohistochemistry on all sebaceous neoplasms means clinically as well as to determine whether all patients with abnormal immunohistochemistry are practically being further worked up for Muir Torre syndrome.
Faculty Mentor: Brent C. Kelly, MD
Elizabeth R. Schepp, MD
Cross Sectional Analysis of Dermatology Patients at a Student-Run Free Clinic: presenting chief complaint and access to care.
Faculty mentor: Alma C. Berlingeri-Ramos, MD
Adrian P. Subrt, MD
Improving Atopic Dermatitis Patient Compliance and Treatment Response with a Treatment Checklist
Attempting to determine the change in patient compliance and treatment response after providing written instructions with a pre-typed checklist with various therapeutic options and having the patient and their parent/guardian watch a video with treatment instructions.
Faculty mentor: TBA
William E. Tausend, MD
Aerosolized Sunscreen Application in Galveston Beachgoers
A study to assess how aerosolized sunscreen is applied and determine whether or not adequate amounts are being used by people going to the beach in Galveston, Texas.
Faculty mentor: Bernard R. Gibson, MD and Richard F. Wagner, Jr., MD, JD