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1.
Am J Dermatopathol ; 45(3): 185-188, 2023 Mar 01.
Article in English | MEDLINE | ID: covidwho-2190875

ABSTRACT

ABSTRACT: To date, over 60% of the world's population has received at least 1 dose of coronavirus disease 2019 (COVID-19) vaccination, with over 12 billion doses administered globally. Commonly reported adverse effects of COVID-19 vaccination include fever, headache, myalgia, and injection site reactions. The spectrum of documented cutaneous reactions after COVID-19 vaccination is broad; however, pityriasis rubra pilaris (PRP) or PRP-like eruption secondary to COVID-19 vaccine is exceedingly rare, with only 17 cases previously reported to date in the English literature. In this article, we describe an additional case of COVID-19 vaccination-associated PRP in a 50-year-old woman with a history of metastatic breast carcinoma, who developed a widespread cutaneous eruption characteristic of PRP, including palmoplantar keratoderma, 10 days after her third dose of Moderna COVID-19 vaccine. Punch biopsy specimen showed epidermal hyperplasia with overlying hyperkeratosis, alternating orthokeratosis and parakeratosis and focal follicular plugging, supporting the diagnosis of PRP. The patient improved within weeks of initiating oral acitretin and topical steroids, with resolution achieved after 3 months of continued therapy. To the best of our knowledge, this is the third reported case of Moderna COVID-19 vaccination-associated PRP and collectively the 18 th after the administration of all COVID-19 vaccines currently available, including Pfizer-BioNTech, and AstraZeneca.


Subject(s)
COVID-19 Vaccines , COVID-19 , Exanthema , Keratoderma, Palmoplantar , Pityriasis Rubra Pilaris , Female , Humans , Middle Aged , 2019-nCoV Vaccine mRNA-1273 , COVID-19/prevention & control , COVID-19/complications , COVID-19 Vaccines/adverse effects , Exanthema/complications , Pityriasis Rubra Pilaris/etiology , Pityriasis Rubra Pilaris/drug therapy , Vaccination/adverse effects
2.
Ann Diagn Pathol ; 54: 151807, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1356125

ABSTRACT

Digital pathology has become an integral part of pathology education in recent years, particularly during the COVID-19 pandemic, for its potential utility as a teaching tool that augments the traditional 1-to-1 sign-out experience. Herein, we evaluate the utility of whole slide imaging (WSI) in reducing diagnostic errors in pigmented cutaneous lesions by pathology fellows without subspecialty training in dermatopathology. Ten cases of 4 pigmented cutaneous lesions commonly encountered by general pathologists were selected. Corresponding whole slide images were distributed to our fellows, along with two sets of online surveys, each composed of 10 multiple-choice questions with 4 answers. Identical cases were used for both surveys to minimize variability in trainees' scores depending on the perceived level of difficulty, with the second set being distributed after random shuffling. Brief image-based teaching slides as self-assessment tool were provided to trainees between each survey. Pre- and post-self-assessment scores were analyzed. 61% (17/28) and 39% (11/28) of fellows completed the first and second surveys, respectively. The mean score in the first survey was 5.2/10. The mean score in the second survey following self-assessment increased to 7.2/10. 64% (7/11) of trainees showed an improvement in their scores, with 1 trainee improving his/her score by 8 points. No fellow scored less post-self-assessment than on the initial assessment. The difference in individual scores between two surveys was statistically significant (p = 0.003). Our study demonstrates the utility of WSI-based self-assessment learning as a source of improving diagnostic skills of pathology trainees in a short period of time.


Subject(s)
COVID-19/prevention & control , Clinical Competence , Education, Distance/methods , Education, Medical, Graduate/methods , Image Interpretation, Computer-Assisted/methods , Pathology, Clinical/education , Skin Diseases/pathology , Diagnostic Errors/prevention & control , Fellowships and Scholarships , Humans , Pathology, Clinical/methods , Skin Diseases/diagnosis , United States
3.
Arch Pathol Lab Med ; 145(1): 22-31, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-1067934

ABSTRACT

CONTEXT.­: As teaching hospitals institute social distancing and defer nonemergent procedures to cope with the coronavirus disease 2019 pandemic, the need for daily on-site presence, unless necessary, has been reduced for all medical staff, including trainees. Pathology training programs must adapt to these changes to ensure overall safety without significantly compromising training and the educational mission of the institution. OBJECTIVE.­: To describe the hybrid on-site and remote anatomic pathology training model in response to the coronavirus disease 2019 pandemic that was implemented in our pathology department and report the clinical fellows' responses to the survey about their experiences. DESIGN.­: The hybrid model was implemented March 25, 2020. Fellows alternate weekly between working on site and working remotely. On site, fellows wear personal protective equipment and maintain social distancing. Remotely, fellows use digital pathology to review cases and supplement with online educational activities. Virtual "coffee breaks," meditation, and exercise are part of the curriculum. Online platforms, including WebEx, Google Classroom, and Canvas, are used to continue educational activities. The survey was open May 19 through June 8, 2020. RESULTS.­: Twenty-eight of the 29 clinical fellows (96%) responded. Many of the respondents indicated substantial increase in their skill with using digital pathology and online platforms during the pandemic. The top most helpful resources were the United States and Canadian Academy of Pathology interactive microscopy courses (found very or somewhat helpful by 22 of 23 clinical fellows; 96%), ExpertPath (19 of 23; 82%), the College of American Pathologists virtual learning series (18 of 23; 78%), the World Health Organization Blue Books (16 of 23; 70%), the American Society of Cytopathology webinars (14 of 23; 61%), and our institutional digital slide collection (12 of 23; 52%). CONCLUSIONS.­: Hybrid on-site and remote training can maximize anatomic pathology learning opportunities while maintaining the safety of trainees, hospital personnel, and the community.


Subject(s)
COVID-19 , Curriculum , Education, Distance/methods , Pathology, Clinical/education , Computer-Assisted Instruction/methods , Education, Distance/trends , Hospitals, Teaching , Humans , Internship and Residency , Pandemics , Physical Distancing , SARS-CoV-2 , Surveys and Questionnaires , Teleworking , Texas , Virtual Reality
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