Dr. Kibbi is a board-certified dermatologist and fellowship-trained dermatologic surgeon. Her clinical interests include Mohs micrographic surgery for skin cancer and laser and injectable treatments to combat aging, sun-damaged skin, and other indications. Her research interests include rare skin tumors, challenging lip lesions, non-invasive treatments, such as photodynamic therapy for non-melanoma skin cancer, and cosmetic procedures for acne scars and autoimmune conditions. Her work has appeared at national and international meetings and has been published in peer-reviewed journals, including Lancet Oncology, Journal of the American Academy of Dermatology, British Journal of Dermatology, Journal of Dermatologic Surgery.
- Mohs surgery
- Cosmetic dermatology
Clinical Assistant Professor, Dermatology
Section Editor, British Journal of Dermatology (2021 - Present)
Chief Resident, Yale Dermatology, Yale School of Medicine (2018 - 2019)
Honors & Awards
Recipient, Mohs Surgeon Leading the Future (MSLF), American College of Mohs Surgery (2021-2022)
Mentorship Award, Women's Dermatologic Society (2018)
Kenneth Fields Award, American Society of Dermatologic Surgery (2017)
Harold H. Lamport Biomedical Research Prize, Yale School of Medicine (2015)
Boards, Advisory Committees, Professional Organizations
Vice President and Board member, Association of Academic Cosmetic Dermatologists (2022 - Present)
Guidelines lead co-author, Committee on Invasive Skin Tumor Evidence-Based Recommendations (CISTERN) (2019 - Present)
Member, American Academy of Dermatology (2016 - Present)
Member, American College of Mohs Surgery (2018 - Present)
Member, American Society of Dermatologic Surgery (2017 - Present)
Board Certification: American Board of Dermatology, Micrographic Dermatologic Surgery (2021)
Board Certification: American Board of Dermatology, Dermatology (2019)
Fellowship: Yale University Dept of Dermatology (2020) CT
Medical Education: Yale School Of Medicine (2015) CT
Residency: Yale University Dept of Dermatology (2019) CT
Internship: Yale University Internal Medicine Residency (2016) CT
Factors affecting outcomes of second intent healing of nasal defects after Mohs micrographic surgery.
Archives of dermatological research
Reconstruction of nasal defects secondary to Mohs micrographic surgery (MMS) presents particular challenges related to the complex topography, skin quality, tissue laxity, and functional and aesthetic concerns of the region. Factors affecting outcomes resulting from second intent healing (SIH) on the nose have not been well described. The purpose of the study was to identify factors impacting outcomes of SIH for nasal tumors following MMS. Retrospective analysis was performed of all nasal lesions treated with MMS followed by SIH from a single surgical center over a 1.5-year period. Ninety-six cases were included. Chart review was performed, and data were collected including age, gender, nasal site, tumor type, defect size, depth, and number of MMS stages. Pre- and post-operative follow-up photographs were available for all cases. All five authors evaluated the photographs using the modified Manchester scar scale. Analysis was then conducted to identify features associated with good outcomes. Of the 96 tumors, 39 lesions (40.6%) were located on the nasal tip (including supratip), 32 (33.3%) on the ala/alar groove, 17 (17.7%) on the sidewall, and 8 (8.3%) on the dorsum. The average defect size was 0.83 cm2 (diameter of 1.06cm±0.4). Defect diameter and defect depth were the factors that significantly impacted scar outcome (p<0.001) in multivariate analysis. No significant functional deficits were reported. This retrospective study suggests that nasal defects with area less than 0.83 cm2 (or 1.06cm diameter) and depth of defect not extending beyond the superficial fat healed well by SIH regardless of location on the nose.
View details for DOI 10.1007/s00403-021-02306-y
View details for PubMedID 35112163
Evidence-Based Clinical Practice Guidelines for Extramammary Paget Disease.
Extramammary Paget disease (EMPD) is a frequently recurring malignant neoplasm with metastatic potential that presents in older adults on the genital, perianal, and axillary skin. Extramammary Paget disease can precede or occur along with internal malignant neoplasms.To develop recommendations for the care of adults with EMPD.A systematic review of the literature on EMPD from January 1990 to September 18, 2019, was conducted using MEDLINE, Embase, Web of Science Core Collection, and Cochrane Libraries. Analysis included 483 studies. A multidisciplinary expert panel evaluation of the findings led to the development of clinical care recommendations for EMPD.The key findings were as follows: (1) Multiple skin biopsies, including those of any nodular areas, are critical for diagnosis. (2) Malignant neoplasm screening appropriate for age and anatomical site should be performed at baseline to distinguish between primary and secondary EMPD. (3) Routine use of sentinel lymph node biopsy or lymph node dissection is not recommended. (4) For intraepidermal EMPD, surgical and nonsurgical treatments may be used depending on patient and tumor characteristics, although cure rates may be superior with surgical approaches. For invasive EMPD, surgical resection with curative intent is preferred. (5) Patients with unresectable intraepidermal EMPD or patients who are medically unable to undergo surgery may receive nonsurgical treatments, including radiotherapy, imiquimod, photodynamic therapy, carbon dioxide laser therapy, or other modalities. (6) Distant metastatic disease may be treated with chemotherapy or individualized targeted approaches. (7) Close follow-up to monitor for recurrence is recommended for at least the first 5 years.Clinical practice guidelines for EMPD provide guidance regarding recommended diagnostic approaches, differentiation between invasive and noninvasive disease, and use of surgical vs nonsurgical treatments. Prospective registries may further improve our understanding of the natural history of the disease in primary vs secondary EMPD, clarify features of high-risk tumors, and identify superior management approaches.
View details for DOI 10.1001/jamaoncol.2021.7148
View details for PubMedID 35050310
- A novel NFkB1 mutation linking pyoderma gangrenosum and common variable immunodeficiency. JAAD case reports 2021; 18: 61-63
- Verrucous candidiasis of the lip: A harbinger of squamous cell carcinoma. JAAD case reports 2021; 16: 168-170
- Development of Objective Structured Assessment of Technical Skills in Facial Cosmetic Procedures: Botulinum Toxin Neuromodulator and Soft Tissue Filler Injection. Journal of the American Academy of Dermatology 2021
Dermatofibrosarcoma protuberans in pregnancy: a case series and review of the literature
INTERNATIONAL JOURNAL OF DERMATOLOGY
Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous sarcoma, which has been reported in pregnancy. This case series reports the clinical and histopathological findings of DFSP in pregnancy.Eighteen cases of DFSP, including six unreported cases and 12 cases from the literature, were identified. Age, anatomic location, tumor size, changes in tumor characteristics during pregnancy, histopathological features, and treatment were recorded. Follow-up data, when available, were noted.The average age of the cohort was 30.6 years (range 19-38). Ten tumors (55.6%) were located on the trunk, four (22.2%) on the head and neck, three (16.7%) on the extremities,and one (5.6%) in the genitalia. Most tumors demonstrated features of conventional DFSP (12/18, 66.7%), while the remaining were identified as DFSP with fibrosarcomatous (FS) change (3/18, 16.7%), atrophic DFSP (2/18, 11.1%), and myxoid DFSP (1/18, 5.6%). Treatment was reported in 17 cases, at least nine of which were treated postpartum. Ten patients were treated with excision, while seven underwent Mohs micrographic surgery. Three patients recurred on follow-up, one with local recurrence and two with distant metastasis.DFSP can undergo enlargement or change in size or color in pregnancy, possibly mediated by hormones. While the majority of cases in this series represented conventional DFSP, unusual clinical and histopathological variants were also present. Treatment in most cases can be safely delayed until after delivery, but recurrent or very large tumors may require treatment prepartum. Close monitoring for recurrence or metastasis is advised.
View details for DOI 10.1111/ijd.15497
View details for Web of Science ID 000636725000001
View details for PubMedID 33818755
- Reflectance Confocal Microscopy as a Promising Adjunctive Tool for Treatment Planning in Extramammary Paget's Disease. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2020
- Broad versus narrow clinical practice guidelines: avoiding rules for the high risk 1. Archives of dermatological research 2020
- Comparative utility of appropriate use criteria versus clinical practice guidelines. Archives of dermatological research 2020
- Multisociety and multispecialty clinical practice guidelines. Archives of dermatological research 2020
- Development of international clinical practice guidelines: benefits, limitations, and alternative forms of international collaboration. Archives of dermatological research 2020
- Principles for developing and adapting clinical practice guidelines and guidance for pandemics, wars, shortages, and other crises and emergencies: the PAGE criteria. Archives of dermatological research 2020
Predicting outcomes following second intent healing of periocular surgical defects.
Archives of dermatological research
Traditionally, second intent healing (SIH) in the periocular region is reserved for small and/or concave defects, particularly those located on the medial canthus.The purpose of this study was to identify factors impacting outcomes of SIH for periocular tumors following Mohs micrographic surgery (MMS).Retrospective analysis was performed of all periocular lesions treated with MMS followed by SIH from a single academic surgical center over a 5-year period. Data regarding tumor characteristics and follow-up was recorded. The modified Manchester scale was utilized to evaluate scar outcomes.Of the 39 tumors included, 14 (35.9%) were located on the lower eyelid, 12 (30.8%) on the upper eyelid, 6 (15.4%) on the lateral canthus, and 7 (17.9%) on the medial canthus. Involvement of the eyelid margin was seen in 11 (28.2%) of cases. The average defect diameter and area were 1.3 cm and 1.04 cm-squared. Twenty-three cases (59.0%) healed with optimal results. Larger defects were significantly associated with poorer outcomes of SIH (odds ratio 0.205, p = 0.017 by multivariate analysis). Anatomic location, involvement of the lid margin, age, and follow-up interval were not significant factors; however, medial canthus defects were least likely to heal with optimal results. On average, medial canthal lesions were larger in size (mean diameter 1.76 cm, mean area 1.97 cm-squared).This retrospective study suggests that periorbital defects in all locations with area less than 1.04 cm2 heal well by SIH. In this cohort, larger lesions on the medial canthus healed with worse outcomes.
View details for DOI 10.1007/s00403-020-02122-w
View details for PubMedID 32833078