
Silvina Pugliese, MD
Clinical Associate Professor, Dermatology
Bio
Silvina Pugliese, M.D., is a Clinical Assistant Professor of Dermatology and Attending Physician at the Stanford Medicine Outpatient Center and Stanford Cancer Institute. She attended medical school at Boston University and completed her residency at Loma Linda, serving as Chief Resident in her final year. Dr. Pugliese practices Supportive Dermato-Oncology (SDO) at the Stanford main campus and also launched the South Bay Cancer Center's SDO Clinic in 2015. She is interested in the management of cutaneous complications associated with chemotherapy, radiation therapy, organ transplantation, and their impact on patient quality of life.
Clinical Focus
- Cancer > Cutaneous (Dermatologic) Oncology
- Dermatology
Honors & Awards
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Peter E. Pochi Award for Excellent in Dermatology, Boston University School of Medicine (2010)
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Mentorship Award, Women’s Dermatologic Society (2013)
Professional Education
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Residency: Loma Linda University (2014)
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Internship: Stanford University Internal Medicine Residency (2011) CA
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Medical Education: Boston University School of Medicine (2010) MA
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Board Certification: American Board of Dermatology, Dermatology (2014)
2023-24 Courses
- Science of Medicine III-B
INDE 223B (Win) -
Prior Year Courses
2022-23 Courses
- Science of Medicine III-B
INDE 223B (Win)
2021-22 Courses
- Science of Medicine III-B
INDE 223B (Win)
- Science of Medicine III-B
All Publications
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Association of Intraoperative Antibiotic Irrigation With Systemic Contact Dermatitis.
JAMA dermatology
2022
Abstract
This case series describes the development of morbilliform drug eruption after breast surgery.
View details for DOI 10.1001/jamadermatol.2022.4458
View details for PubMedID 36383358
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Consensus on the Clinical Management of Chronic Radiation Dermatitis and Radiation Fibrosis: A Delphi Survey.
The British journal of dermatology
2022
View details for DOI 10.1111/bjd.21852
View details for PubMedID 36047980
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Partnering with a senior living community to optimize teledermatology via full body skin screening during the COVID-19 pandemic: a pilot program
Skin Health and Disease
2022
View details for DOI 10.1002/ski2.141
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NUTRITIONAL DEFICIENCY CONTRIBUTING TO REFRACTORY ERYTHRODERMA IN HEMATOPOETIC CELL TRANSPLANT PATIENTS: DISTINCTIVE CLINICAL AND HISTOPATHOLOGICAL FINDINGS.
Journal of the American Academy of Dermatology
2021
View details for DOI 10.1016/j.jaad.2021.07.077
View details for PubMedID 34450206
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Drug-induced hypersensitivity syndrome like reaction with angioedema and hypotension associated with BRAF inhibitor use and antecedent immune checkpoint therapy.
JAAD case reports
2021; 13: 147-151
View details for DOI 10.1016/j.jdcr.2021.04.033
View details for PubMedID 34195327
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Disseminated Tuberculosis Presenting as Medium-Vessel Vasculitis in an Immunocompromised Host.
Journal of cutaneous pathology
2020
Abstract
Cutaneous tuberculosis is an uncommon entity with several clinical forms recognized. Histopathologically, most cases are characterized by granulomatous inflammation and caseating necrosis, though less common findings, including vasculitis, have also been described. We report a 55-year-old male with a history of recently diagnosed dermatomyositis receiving immunosuppression with mycophenolate mofetil and prednisone, who developed multifocal soft tissue abscesses and an indurated erythematous plaque on the back. Skin biopsy of the back revealed a necrotizing medium-vessel vasculitis. M. tuberculosis was detected in the skin via acid-fast bacilli stain and confirmed by tissue culture and polymerase chain reaction. Cutaneous findings improved rapidly with anti-tuberculosis therapy. This case illustrates an uncommon clinical and histopathologic presentation of disseminated tuberculosis. This article is protected by copyright. All rights reserved.
View details for DOI 10.1111/cup.13678
View details for PubMedID 32133689
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Pityriasis rubra pilaris-like graft-vs-host disease following allogeneic stem cell transplant in two patients.
Clinical case reports
2019; 7 (12): 2491-2494
Abstract
Chronic cutaneous graft-vs-host disease (GVHD) has several atypical variants. We describe two cases of GVHD with clinical and histopathologic features of pityriasis rubra pilaris (PRP), which responded to additional immunosuppression. Recognition of this newly described PRP-like clinical presentation of GVHD may prompt early consideration of additional steroid-sparing therapies.
View details for DOI 10.1002/ccr3.2458
View details for PubMedID 31893086
View details for PubMedCentralID PMC6935619
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Pityriasis rubra pilaris-like graft-vs-host disease following allogeneic stem cell transplant in two patients
CLINICAL CASE REPORTS
2019
View details for DOI 10.1002/ccr3.2458
View details for Web of Science ID 000496342800001
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Association of Antibiotic Resistance With Antibiotic Use for Epidermal Growth Factor Receptor Inhibitor-Related Papulopustular Eruption
JAMA DERMATOLOGY
2019; 155 (7): 848–50
View details for DOI 10.1001/jamadermatol.2019.0063
View details for Web of Science ID 000482127300016
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Association of Antibiotic Resistance With Antibiotic Use for Epidermal Growth Factor Receptor Inhibitor-Related Papulopustular Eruption.
JAMA dermatology
2019
View details for PubMedID 31017625
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Localized bullous pemphigoid in a melanoma patient with dual exposure to PD-1 checkpoint inhibition and radiation therapy.
JAAD case reports
2017; 3 (5): 404–6
View details for PubMedID 28884139
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Cutaneous Complications of Targeted Melanoma Therapy (17, 57, 2016)
CURRENT TREATMENT OPTIONS IN ONCOLOGY
2016; 17 (12): 63
View details for PubMedID 27817056
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Cutaneous Complications of Targeted Melanoma Therapy.
Current treatment options in oncology
2016; 17 (11): 57-?
Abstract
The landscape of advanced and metastatic melanoma therapy has shifted dramatically in recent years. Since 2011, eight drugs (ipilimumab, vemurafenib, dabrafenib, trametinib, cometinib, pembrolizumab, nivolumab, and talimogene laherparepvec) have received FDA approval for the treatment of advanced or metastatic melanoma, including combination regimens of both small molecule kinase and immune checkpoint inhibitors. These therapies have revolutionized the management of unresectable regional nodal and distant melanoma, providing hope of extended survival to patients. As the use of novel agents has increased, so have the cutaneous toxicities associated with these medications. While most skin reactions are low-grade and can be managed conservatively with topical therapies, malignant lesions and more serious or life-threatening drug reactions can arise during therapy, requiring prompt dermatologic recognition and treatment in order to improve patient outcome. Given the survival benefit attributed to these new agents, treating skin toxicity and maintaining patient quality of life is of paramount importance. Oncologists should be aware of the common cutaneous toxicities associated with these medications and should be encouraged to involve dermatologists in the collaborative care of advanced melanoma patients. Close communication between oncologists and dermatologists can help to avoid unnecessary dose reduction or treatment discontinuation and identify situations when treatment cessation is truly warranted.
View details for DOI 10.1007/s11864-016-0434-0
View details for PubMedID 27645330
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Management of Dermatologic Complications of Lung Cancer Therapies.
Current treatment options in oncology
2015; 16 (10): 50-?
Abstract
In recent years, oncogene-directed targeted agents and immunotherapies have expanded the treatment armamentarium for advanced lung cancer and, in particular, non-small cell lung cancer (NSCLC). Along with extended survival, these agents are accompanied by a host of cutaneous complications that affect the skin, hair, and nails. These skin complications range from the well-characterized papulopustular (acneiform) eruption of the epidermal growth factor receptor (EGFR) inhibitors to the emerging characterization of lichenoid skin eruptions seen during treatment with antibodies targeting the programmed cell death protein 1 (PD-1) and programmed cell death protein 1 ligand (PD-L1). When promptly recognized and accurately diagnosed, most cutaneous adverse events can be managed with supportive treatments, avoiding the need to interrupt antitumor therapy. Furthermore, preemptive management of skin problems can lead to significantly decreased severity of many cutaneous complications of these therapies. We encourage close collaboration between dermatologists and oncologists to better characterize cutaneous toxicity, select appropriate management, and avoid unnecessary dose reduction or discontinuation while simultaneously improving patient quality of life.
View details for DOI 10.1007/s11864-015-0368-y
View details for PubMedID 26338208
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Management of Dermatologic Complications of Lung Cancer Therapies.
Current treatment options in oncology
2015; 16 (10): 368-?
Abstract
In recent years, oncogene-directed targeted agents and immunotherapies have expanded the treatment armamentarium for advanced lung cancer and, in particular, non-small cell lung cancer (NSCLC). Along with extended survival, these agents are accompanied by a host of cutaneous complications that affect the skin, hair, and nails. These skin complications range from the well-characterized papulopustular (acneiform) eruption of the epidermal growth factor receptor (EGFR) inhibitors to the emerging characterization of lichenoid skin eruptions seen during treatment with antibodies targeting the programmed cell death protein 1 (PD-1) and programmed cell death protein 1 ligand (PD-L1). When promptly recognized and accurately diagnosed, most cutaneous adverse events can be managed with supportive treatments, avoiding the need to interrupt antitumor therapy. Furthermore, preemptive management of skin problems can lead to significantly decreased severity of many cutaneous complications of these therapies. We encourage close collaboration between dermatologists and oncologists to better characterize cutaneous toxicity, select appropriate management, and avoid unnecessary dose reduction or discontinuation while simultaneously improving patient quality of life.
View details for DOI 10.1007/s11864-015-0368-y
View details for PubMedID 26338208
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Cosmetic benefits of natural ingredients.
Journal of drugs in dermatology : JDD
2014; 13 (9): 1021-5
Abstract
Photoaging is a leading concern for patients and many of these patients will express a desire to utilize natural ingredients as treatment. Mushrooms, feverfew, green tea, licorice, olive oil, soy, and coffee berry have been shown to have antioxidant properties and may play a role in the treatment and prevention of photoaging. In this manuscript, the most recent select basic science and clinical studies examining the mechanisms and efficacy of these ingredients will be discussed.
J Drugs Dermatol. 2014;13(9):1021-1025.View details for PubMedID 25226001
- Favre-Racouchot Syndrome Acneiform Eruptions in Dermatology Springer Publishing. 2013: 253–257
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Multicenter Photopheresis Intervention Trial in Early-Stage Mycosis Fungoides
CLINICAL LYMPHOMA MYELOMA & LEUKEMIA
2011; 11 (2): 219-227
Abstract
To demonstrate the efficacy of the UVAR XTS Photopheresis System and evaluate health-related quality of life in patients with early-stage mycosis fungoides (MF).Extracorporeal photopheresis was administered 2 days every 4 weeks for 6 months. Patients with partial responses by skin weighted assessment continued for 6 months; nonresponders added oral bexarotene and/or interferon α. Health-related quality of life was assessed at baseline and every 3 months with 3 validated tools.Nineteen patients with early-stage MF (7 men, 12 women; 16 white, 3 African Americans) with median age of 63.5 years (range, 46-85 years) participated. Their stages were IA (n = 3), IB (n = 14), and IIA (n = 2). The overall response rate for extracorporeal photopheresis (ECP) alone, was 42% (8/19; including 7 partial response, 1 complete response), with a median of 12 ECP sessions (range, 3-32) given over a median of 12 months (3-32 months) and with an overall duration of response of 6.5 months (range, 1-48 months). Seven patients with stable disease at 3 months received additional bexarotene (3/5; 1 complete response) or bexarotene plus interferon α (1/2), and 4 (57%) of 7 responded. Treatment-related adverse effects were limited to those expected with interferon (fatigue, nausea, vomiting, and diarrhea), or with hypertriglyceridemia and bexarotene. Trends in health-related quality of life indicated an improvement in emotional scores over time.ECP is effective for patients with early-stage MF alone or in combination with biologic response modifiers with low toxicity and improved quality of life.
View details for DOI 10.1016/j.dml.2011.03.003
View details for Web of Science ID 000291235900006
View details for PubMedID 21575927
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DermHub: A comprehensive dermatology-focused patient education resource and social community
MOSBY-ELSEVIER. 2011: AB78
View details for Web of Science ID 000286780500305
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Adverse Reaction to Cutaneous Injection of Contents From a Vitamin E Liquid-Containing Capsule
ARCHIVES OF DERMATOLOGY
2010; 146 (4): 454-455
View details for Web of Science ID 000276813500028
View details for PubMedID 20404248