Audris Chiang, MD

All Publications

• Prevalence and risk factors for high frequency basal cell carcinoma in the United States. Journal of the American Academy of Dermatology Chiang, A. n., Solis, D. C., Rogers, H. n., Sohn, G. K., Cho, H. G., Saldanha, G. n., Lapidus, D. n., Li, S. n., Sarin, K. Y., Tang, J. Y. 2020

  View details for DOI 10.1016/j.jaad.2020.07.088

  View details for PubMedID 32735972

• Genetic mutations underlying phenotypic plasticity in basosquamous carcinoma Journal of Investigative Dermatology Chiang, A., Tan, C. Z., Kuonen, F., Hodgkinson, L. M., Chiang, F., Cho, R. J., South, A. P., Tang, J. Y., Chang, A. L., Rieger, K. E., Oro, A. E., Sarin, K. Y. 2019

  View details for DOI 10.1016/j.jid.2019.03.1163

• Genomic Stability in Syndromic Basal Cell Carcinoma. The Journal of investigative dermatology Chiang, A. n., Jaju, P. D., Batra, P. n., Rezaee, M. n., Epstein, E. H., Tang, J. Y., Sarin, K. Y. 2017

  Abstract

  Basal cell cancers (BCCs) are characterized by up-regulation of Hedgehog pathway through loss of Patched1 or activation of Smoothened, and smoothened-inhibitors such as vismodegib are effective therapies for advanced BCCs. Although most BCCs are sporadic, rare individuals with Basal Cell Nevus Syndrome (BCNS) harbor germline defects in Patched1 and develop up to hundreds of tumors that are histopathologically indistinguishable from sporadic BCCs. Interestingly, BCNS-BCCs are more responsive to Smoothened-inhibitors than sporadic BCCs, with minimal development of resistance. Given differences in clinical course and therapy response, we sought to characterize BCCs in the setting of BCNS. We found that BCNS individuals with low-tumor burden demonstrated significantly fewer UV signature somatic mutations and lower overall somatic mutational load compared to BCNS individuals with high-burden, supporting a role of UV exposure in driving BCC development in BCNS individuals. However, compared with sporadic BCCs, BCNS-BCCs have a significantly lower mutational load, lower proportion of ultraviolet mutagenesis, increased genomic stability, and harbor fewer functionally resistant Smoothened mutations at baseline, explaining why BCNS-BCCs lack intrinsic resistance to Smoothened-inhibitors. BCNS-BCCs appear to have reduced mutator phenotype as compared with sporadic BCCs, which may contribute to their relatively more indolent clinical course and responsiveness to therapy.

  View details for PubMedID 29111235

• Acanthosis nigricans in the setting of severe pulmonary disease exacerbated by COVID-19 infection. JAAD case reports Hirotsu, K. E., Chiang, A., Bahrani, E., Cloutier, J. M., Rieger, K. E., Kwong, B. Y., Aleshin, M. 2022

  View details for DOI 10.1016/j.jdcr.2022.04.017

  View details for PubMedID 35529073

• Central Nervous System Xanthoma Disseminatum: Response to 2CdA in an Adolescent. Case reports in pediatrics DeMoss, P., Tang, N., Yeom, K., Chiang, A., Marqueling, A. L., Jeng, M. R. 2022; 2022: 9906668

  Abstract

  Xanthoma disseminatum is a normolipemic non-Langerhans cell histiocytosis characterized by red-brown rubbery papules of the skin which coalesce into plaque-like lesions with symmetric involvement of face, flexor, and intertriginous areas. Less commonly, xanthoma disseminatum may affect mucosal linings, abdominal organs, and the central nervous system, leading to endocrinopathies. We report a 12-year-old adolescent with mucosal, central nervous system, and painful cutaneous lesions, further complicated by diabetes insipidus and amenorrhea. Treatment with 2-chlorodeoxyadenosine led to relief of pain and significant improvement of mucosal, central nervous system, and cutaneous lesions, with subsequent restoration of menstrual cycles.

  View details for DOI 10.1155/2022/9906668

  View details for PubMedID 35910691

• Response to Clarifying the Current Understanding of Syndromic Basal Cell Carcinomas. The Journal of investigative dermatology Chiang, A., Batra, P., Sarin, K. Y. 2019

  Abstract

  A majority of individuals with BCNS have germline mutations affecting PTCH1, and BCCs that develop in these individuals are highly responsive to Smoothened inhibitors. However, BCCs which develop in minority of BCNS patients with underlying SUFU mutations may be less responsive to Smoothened inhibitors because inactivation of SUFU is downstream of SMO. Development of next-generation HH antagonists that target components downstream of SMO are under development for efficacy in Smoothened inhibitor resistant BCCs and may have efficacy in BCCs with SUFU mutations.

  View details for DOI 10.1016/j.jid.2019.06.139

  View details for PubMedID 31330148

• Balance of tofacitinib efficacy and disease flare in the treatment of alopecia universalis: A case report and review of the literature. JAAD case reports Chiang, A., Ortenzio, F., Juhasz, M. L., Yu, V., Mesinkovska, N. A. 2018; 4 (7): 733-736

  View details for DOI 10.1016/j.jdcr.2018.04.006

  View details for PubMedID 30167448

• Classic autoimmune type 1 diabetes mellitus after a case of drug reaction with eosinophilia and systemic symptoms (DRESS). JAAD case reports Chiang, A., Shiu, J., Elsensohn, A. N., Chapman, L. W., de Feraudy, S., Smith, J. 2018; 4 (4): 295-297

  View details for DOI 10.1016/j.jdcr.2017.10.003

  View details for PubMedID 29693052

• Standard dermoscopy and videodermoscopy as tools for medical student dermatologic education. Dermatology practical & conceptual Cho, H. G., Sheu, S. L., Chiang, A., Nord, K. M. 2018; 8 (1): 39–42

  View details for PubMedID 29445573

• Alopecia and Associated Toxic Agents: A Systematic Review SKIN APPENDAGE DISORDERS Yu, V., Juhasz, M., Chiang, A., Mesinkovska, N. 2018; 4 (4): 245-260

  Abstract

  There are a number of toxic agents that can cause alopecia. In this review we summarize the known substances that cause alopecia as one of the clinical signs of overdose or toxicity.A search was conducted using PubMed, EMBASE, and Cochrane for studies describing hair loss of any type as a result of exposure to or ingestion of a toxic agent. The search yielded 856 articles, with 47 studies included in this review.Agents with the strongest evidence of association to alopecia include thallium, mercury, selenium, and colchicine. Agents with described incidents include boric acid, arsenic, vitamin A, botulinum toxin, Podostroma cornu-damae, and the synthetic opioid MT-45.Numerous toxic agents have been implicated in alopecia, and the strength of evidence behind each agent varies. Toxic levels of thallium and colchicine have long been established to cause alopecia, as compared to agents such as botulinum toxin A and synthetic recreational drugs which have less literature describing their links to alopecia and will need further investigation to characterize their relationships to hair loss. Knowledge of typical presentations of hair loss will aid in the development of a differential diagnosis for patients presenting with alopecia.

  View details for DOI 10.1159/000485749

  View details for Web of Science ID 000448892600007

  View details for PubMedID 30410891

  View details for PubMedCentralID PMC6219226

• Standard dermoscopy and videodermoscopy as tools for medical student dermatologic education DERMATOLOGY PRACTICAL & CONCEPTUAL Cho, H. G., Sheu, S. L., Chiang, A., Nord, K. M. 2018; 8 (1): 39–42

  View details for DOI 10.5826/dpc.0801a08

  View details for Web of Science ID 000580857300008

• Postzygotic Mutations in Beta-Actin are Associated with Becker's Nevus and Becker's Nevus Syndrome. journal of investigative dermatology Cai, E. D., Sun, B. K., Chiang, A., Rogers, A., Bernet, L., Cheng, B., Teng, J., Rieger, K. E., Sarin, K. Y. 2017

  View details for DOI 10.1016/j.jid.2017.03.017

  View details for PubMedID 28347698

• Localized bullous pemphigoid in a melanoma patient with dual exposure to PD-1 checkpoint inhibition and radiation therapy. JAAD case reports Hirotsu, K. n., Chiou, A. S., Chiang, A. n., Kim, J. n., Kwong, B. Y., Pugliese, S. n. 2017; 3 (5): 404–6

  View details for PubMedID 28884139

• Stratum corneum reservoir as a predictive method for in vitro percutaneous absorption JOURNAL OF APPLIED TOXICOLOGY Hafeez, F., Chiang, A., Hui, X., Zhu, H., Kamili, F., Maibach, H. I. 2016; 36 (8): 1003-1010

  View details for DOI 10.1002/jat.3262

  View details for Web of Science ID 000378570300004

• Role of partition coefficients in determining the percutaneous penetration of salicylic acid and formaldehyde under varying occlusion durations DRUG DEVELOPMENT AND INDUSTRIAL PHARMACY Hafeez, F., Chiang, A., Hui, X., Maibach, H. 2014; 40 (10): 1395-1401

  Abstract

  Occlusion is widely utilized to enhance the percutaneous penetration of applied drugs in clinical practice; however, occlusion does not increase the penetration of all chemicals.This study determines: (1) whether occlusion enhances the percutaneous penetration of the lipophilic salicylic acid or the hydrophilic formaldehyde when compared to non-occlusion, (2) evaluate whether occlusion duration affects the penetration of compounds and (3) establish to what extent occlusive films in clinical practice interact with topically-applied chemicals and possibly hinder penetration.Separately, single doses of [14C]-formaldehyde and [14C]-salicylic acid were applied onto human skin overlying diffusion cells under non-occlusion as well as various occlusive time periods (1, 4 and 8 h). The percent dose penetrating into each compartment as well the percent dose adhering to the plastic wrap were determined.The radioactivity recovery as percent of applied dose of [14C]-salicylic acid was significantly higher under occlusion versus non-occlusion in the epidermis, dermis and receptor fluid after 24 h (p < 0.05). For [14C]-formaldehyde, no significant statistical differences were observed between occlusion versus non-occlusion. The plastic wrap often used to enhance the penetration of topically applied drugs does not itself substantially adhere to the tested chemicals.Occlusion duration, previously undocumented for in vitro studies, impacted the percutaneous penetration of the lipophilic salicylic acid more so than the hydrophilic formaldehyde. A strong correlation between occlusion-enhanced penetration and partition coefficients was observed, but we do not wish to overgeneralize these results until more compounds of varying physical--chemical properties are studied.

  View details for DOI 10.3109/03639045.2013.828218

  View details for Web of Science ID 000343926400014

  View details for PubMedID 23937557

• Transungual delivery of ketoconazole using novel lacquer formulation INTERNATIONAL JOURNAL OF PHARMACEUTICS Hafeez, F., Hui, X., Chiang, A., Hornby, S., Maibach, H. 2013; 456 (2): 357-361

  Abstract

  Onychomycosis, a common fungal infection of the nail, can have a substantial impact on quality of life. The success of topical therapy for onychomycosis depends on effective penetration, which can be enhanced using an appropriate delivery method. This study evaluated the effectiveness of a novel topical lacquer on enhancing [(14)C]-ketoconazole penetration by comparing nail absorption, nail distribution, and nail penetration of [(14)C]-ketoconazole dissolved in the novel lacquer versus a commercial ketoconazole cream. Using the in vitro finite dose model, the formulations were applied daily to human nail plates for 7 days. Drug absorption was measured by monitoring rate of appearance in each nail layer and the supporting bed. After the multiple day treatment, cumulative concentrations of ketoconazole formulated in novel lacquer in the deep nail layer and the nail bed were significantly greater than cumulative concentrations of commercial ketoconazole (p<0.05), as well as several orders of magnitude greater than the minimal inhibitory concentration (MIC) deemed necessary to inhibit the growth of causative dermatophytic and yeast species. These results suggest that this novel ketoconazole lacquer has the potential to be an effective topical treatment for onychomycosis.

  View details for DOI 10.1016/j.ijpharm.2013.08.082

  View details for Web of Science ID 000325644600012

  View details for PubMedID 24029171

• Towards a perfect vehicle(s) for diagnostic patch testing: an overview CUTANEOUS AND OCULAR TOXICOLOGY Chiang, A., Maibach, H. I. 2013; 32 (1): 60-66

  Abstract

  The correct selection of vehicles for patch testing is crucial in evaluating suspected allergic contact dermatitis. We reviewed literature by searching Pubmed and Embase for the years 1971-2011 utilizing the subjects "vehicle," "allergic contact dermatitis" and "patch test" for advances in knowledge of vehicles." A universal optimal vehicle more efficient than petrolatum remains undiscovered. Literature provides research supporting alternate vehicles for specific allergens and insights on vehicle characteristics, such as influence on bioavailability of chemicals and subsequent percutaneous absorption or interaction with allergens. These findings should accelerate our ability to define, and thus determine, the optimum vehicle(s).

  View details for DOI 10.3109/15569527.2012.684418

  View details for Web of Science ID 000310618400013

  View details for PubMedID 22667342