Maria Alexandrovna Aleshin, MD

All Publications

• Hidradenitis suppurativa and Ehlers-Danlos syndrome: A case-control study. JAAD international Hua, V. J., Li, S., Sarin, K. Y., Aleshin, M. 2023; 12: 70-71

  View details for DOI 10.1016/j.jdin.2023.03.008

  View details for PubMedID 37274386

  View details for PubMedCentralID PMC10236182

• A practical guide to starting a hidradenitis suppurativa specialty clinic. JAAD international Shih, T., Lee, K., Aleshin, M., Bennett, R., Mayo, T., Okoye, G. A., Villa, N., Sayed, C. J., Shi, V. Y., Hsiao, J. L. 2023; 11: 117-120

  View details for DOI 10.1016/j.jdin.2023.01.021

  View details for PubMedID 36950265

• Erythema Gyratum Repens Secondary to Pulmonary Tuberculosis. Annals of internal medicine Contag, C. A., Maloney, N., Tayyar, R., Aleshin, M. A., Novoa, R. A., Ho, D. Y. 2023

  View details for DOI 10.7326/L22-0453

  View details for PubMedID 36913686

• Addition of intravenous immunoglobulin therapy to facilitate resolution of steroid-refractory DRESS syndrome Kumar, A. M., Besen, J., Aleshin, M. MOSBY-ELSEVIER. 2022: AB13

  View details for Web of Science ID 000891793200049

• Teledermatology to Facilitate Patient Care Transitions From Inpatient to Outpatient Dermatology: Mixed Methods Evaluation. Journal of medical Internet research Kling, S. M., Saliba-Gustafsson, E. A., Winget, M., Aleshin, M. A., Garvert, D. W., Amano, A., Brown-Johnson, C. G., Kwong, B. Y., Calugar, A., El-Banna, G., Shaw, J. G., Asch, S. M., Ko, J. M. 2022; 24 (8): e38792

  Abstract

  BACKGROUND: Both clinicians and patients have increasingly turned to telemedicine to improve care access, even in physical examination-dependent specialties such as dermatology. However, little is known about whether teledermatology supports effective and timely transitions from inpatient to outpatient care, which is a common care coordination gap.OBJECTIVE: Using mixed methods, this study sought to retrospectively evaluate how teledermatology affected clinic capacity, scheduling efficiency, and timeliness of follow-up care for patients transitioning from inpatient to outpatient dermatology care.METHODS: Patient-level encounter scheduling data were used to compare the number and proportion of patients who were scheduled and received in-clinic or video dermatology follow-ups within 14 and 90 days after discharge across 3 phases: June to September 2019 (before teledermatology), June to September 2020 (early teledermatology), and February to May 2021 (sustained teledermatology). The time from discharge to scheduling and completion of patient follow-up visits for each care modality was also compared. Dermatology clinicians and schedulers were also interviewed between April and May 2021 to assess their perceptions of teledermatology for postdischarge patients.RESULTS: More patients completed follow-up within 90 days after discharge during early (n=101) and sustained (n=100) teledermatology use than at baseline (n=74). Thus, the clinic's capacity to provide follow-up to patients transitioning from inpatient increased from baseline by 36% in the early (101 from 74) and sustained (100 from 74) teledermatology periods. During early teledermatology use, 61.4% (62/101) of the follow-ups were conducted via video. This decreased significantly to 47% (47/100) in the following year, when COVID-19-related restrictions started to lift (P=.04), indicating more targeted but still substantial use. The proportion of patients who were followed up within the recommended 14 days after discharge did not differ significantly between video and in-clinic visits during the early (33/62, 53% vs 15/39, 38%; P=.15) or sustained (26/53, 60% vs 28/47, 49%; P=.29) teledermatology periods. Interviewees agreed that teledermatology would continue to be offered. Most considered postdischarge follow-up patients to be ideal candidates for teledermatology as they had undergone a recent in-person assessment and might have difficulty attending in-clinic visits because of competing health priorities. Some reported patients needing technological support. Ultimately, most agreed that the choice of follow-up care modality should be the patient's own.CONCLUSIONS: Teledermatology could be an important tool for maintaining accessible, flexible, and convenient care for recently discharged patients needing follow-up care. Teledermatology increased clinic capacity, even during the pandemic, although the timeliness of care transitions did not improve. Ultimately, the care modality should be determined through communication with patients to incorporate their and their caregivers' preferences.

  View details for DOI 10.2196/38792

  View details for PubMedID 35921146

• 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

• Hidradenitis Suppurativa in Sexual and Gender Minorities: A Review and Considerations for Providers. Journal of the American Academy of Dermatology Gomez, J., Barnes, L. A., Yost, J. M., Gordon, J., Ginsberg, B. A., Aleshin, M. 2022

  Abstract

  The literature on hidradenitis suppurativa (HS) in sexual and gender minorities (SGM) remains sparse. This review article aims to discuss critical factors for providers to consider in LGBTQIA patients with HS, including associated comorbidities, gender-affirming hormonal therapy, squamous cell carcinoma, infections in HIV-positive patients, and creating a welcoming clinic for SGM patients.

  View details for DOI 10.1016/j.jaad.2022.03.008

  View details for PubMedID 35283243

• Pyoderma Gangrenosum After Bilateral Total Knee Arthroplasty. Arthroplasty today Loomis, R., Merrit, M., Aleshin, M. A., Graw, G., Lee, G., Graw, B. 2021; 11: 73-79

  Abstract

  Pyoderma gangrenosum is a neutrophilic dermatosis, which mimics both infection and necrotizing fasciitis, that can present after surgical interventions. We present the case of a 62-year-old male who underwent one-stage bilateral total knee arthroplasty. Nine days after the surgery, he presented with wound breakdown, high fever, and elevated white blood cell count. Repeated debridement was performed, and empiric antibiotics were given. All tissue cultures and aspirates remained negative throughout treatment course, and the patient remained unresponsive to therapy. The patient was eventually diagnosed with pyoderma gangrenosum after infectious etiologies were ruled out and after a skin biopsy and dermatologic consultation. His condition rapidly improved after treatment with corticosteroids, and soft-tissue defects were repaired with skin substitute and full-thickness skin grafting. In patients with aseptic wound breakdown after total knee arthroplasty, pyoderma gangrenosum is a rare but devastating complication and should be considered.

  View details for DOI 10.1016/j.artd.2021.07.003

  View details for PubMedID 34485653

• Hemophagocytic lymphohistiocytosis secondary to progressive disseminated histoplasmosis presenting as cellulitis. Medical mycology case reports Puing, A. G., Raghavan, S. S., Aleshin, M. A., Ho, D. Y. 2021; 33: 18-20

  Abstract

  Histoplasmosis-associated hemophagocytic lymphohistiocytosis is a rate but lethal disease in immunocompromised hosts. Unusual clinical presentations make diagnosing invasive fungal infection even more challenging. Here we present a case of hemophagocytic lymphohistiocytosis secondary to progressive disseminated histoplasmosis presenting as cellulitis in a patient with systemic lupus erythematous. A high index of suspicion combined with histopathology and molecular diagnostic techniques are important to establish an accurate and timely diagnosis of opportunistic infections in immunocompromised patients.

  View details for DOI 10.1016/j.mmcr.2021.06.002

  View details for PubMedID 34307009

• Histopathologic correlation of skin manifestations of multisystemic inflammatory syndrome in adults (MIS-A) associated with SARS-CoV-2 infection. JAAD case reports So, N. A., So, J., Centkowski, S., Rana, J., Aleshin, M., Kwong, B. Y., Rieger, K., Zaba, L. C., Chiou, A. S. 2021

  View details for DOI 10.1016/j.jdcr.2021.06.031

  View details for PubMedID 34405113

• Phenotypic characteristics of T cells co-expressing SOX2, OCT3/4, and NANOG Cerniglia, M., Escuin-Ordinas, H., Porter, C., Aleshin, M., Cheung-Lau, G., Galic, Z., Abraham-Davidi, I., Shin, D., Rosenblatt-Rosen, O., Ribas, A., Comin-Anduix, B. AMER ASSOC CANCER RESEARCH. 2021

  View details for Web of Science ID 000680263502190

• Efficacy of Etanercept in the Treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. Cutis Dreyer, S. D., Torres, J., Stoddard, M., Leavitt, E., Sutton, A., Aleshin, M., Crew, A., Worswick, S. 2021; 107 (6): E22-E28

  Abstract

  It has been suggested that the use of etanercept for treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) might provide improved mortality benefit and decreased skin healing times. This retrospective study compared the use of single-dose subcutaneous etanercept to intravenous immunoglobulin (IVIG) and supportive care alone. Thirteen patients were treated with a single dose (50 mg) of subcutaneous etanercept. Results of this study support the use of etanercept as a potentially beneficial agent in the treatment of SJS/TEN.

  View details for DOI 10.12788/cutis.0288

  View details for PubMedID 34314327

• Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Multicenter Retrospective Study of 377 Adult Patients from the United States (vol 138, pg 2315, 2018) JOURNAL OF INVESTIGATIVE DERMATOLOGY Micheletti, R. G., Chiesa-Fuxench, Z., Noe, M. H., Stephen, S., Aleshin, M., Agarwal, A., Boggs, J., Cardones, A. R., Chen, J. K., Cotliar, J., Davis, M. P., Dominguez, A., Fox, L. P., Gordon, S., Hamrick, R., Ho, B., Hughey, L. C., Jones, L. M., Kaffenberger, B. H., Kindley, K., Kroshinsky, D., Kwong, B. Y., Miller, D. D., Mostaghimi, A., Musiek, A., Ortega-Loayza, A. G., Patel, R., Posligua, A., Rani, M., Saluja, S., Sharon, V. R., Shinkai, K., St John, J., Strickland, N., Summers, E. M., Sun, N., Wanat, K. A., Wetter, D. A., Worswick, S., Yang, C., Margolis, D. J., Gelfand, J. M., Rosenbach, M. 2019; 139 (2): 495–96

  View details for DOI 10.1016/j.jid.2018.11.013

  View details for Web of Science ID 000456162000049

• Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Multicenter Retrospective Study of 377 Adult Patients from the United States JOURNAL OF INVESTIGATIVE DERMATOLOGY Micheletti, R. G., Chiesa-Fuxench, Z., Noe, M. H., Stephen, S., Aleshin, M., Agarwal, A., Boggs, J., Cardones, A. R., Chen, J. K., Cotliar, J., Davis, M. P., Dominguez, A., Fox, L. P., Gordon, S., Hamrick, R., Ho, B., Hughey, L. C., Jones, L. M., Kaffenberger, B. H., Kindley, K., Kroshinsky, D., Kwong, B. Y., Miller, D. D., Mostaghimi, A., Musiek, A., Ortega-Loayza, A. G., Patel, R., Posligua, A., Rani, M., Saluja, S., Sharon, V. R., Shinkai, K., St John, J., Strickland, N., Sun, N., Wanat, K. A., Wetter, D. A., Worswick, S., Yang, C., Margolis, D. J., Gelfand, J. M., Rosenbach, M. 2018; 138 (11): 2315–21

  Abstract

  Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a rare, severe mucocutaneous reaction with few large cohorts reported. This multicenter retrospective study included patients with SJS/TEN seen by inpatient consultative dermatologists at 18 academic medical centers in the United States. A total of 377 adult patients with SJS/TEN between January 1, 2000 and June 1, 2015 were entered, including 260 of 377 (69%) from 2010 onward. The most frequent cause of SJS/TEN was medication reaction in 338 of 377 (89.7%), most often to trimethoprim/sulfamethoxazole (89/338; 26.3%). Most patients were managed in an intensive care (100/368; 27.2%) or burn unit (151/368; 41.0%). Most received pharmacologic therapy (266/376; 70.7%) versus supportive care alone (110/376; 29.3%)-typically corticosteroids (113/266; 42.5%), intravenous immunoglobulin (94/266; 35.3%), or both therapies (54/266; 20.3%). Based on day 1 SCORTEN predicted mortality, approximately 78 in-hospital deaths were expected (77.7/368; 21%), but the observed mortality of 54 patients (54/368; 14.7%) was significantly lower (standardized mortality ratio = 0.70; 95% confidence interval = 0.58-0.79). Stratified by therapy received, the standardized mortality ratio was lowest among those receiving both steroids and intravenous immunoglobulin (standardized mortality ratio = 0.52; 95% confidence interval 0.21-0.79). This large cohort provides contemporary information regarding US patients with SJS/TEN. Mortality, although substantial, was significantly lower than predicted. Although the precise role of pharmacotherapy remains unclear, co-administration of corticosteroids and intravenous immunoglobulin, among other therapies, may warrant further study.

  View details for PubMedID 29758282