FROM THE CHIEF. - Dear Friends of UCSD Dermatology,

Despite the challenges of 2009, this year has been one of continued growth and success for UCSD Dermatology. In this newsletter we will introduce to you several new members of our family, repre-senting success in our efforts for excellence in clinical care, education and research. I am par-ticularly happy to welcome our newest full time faculty members Dr. Robert Lee and Dr. Jo-seph Lillis. Dr Lee comes to us from the University of Pennsylvania and is heading up our der-matopathology service with an immediate goal of modernizing many aspects of the information processing and communication system. Dr. Lillis comes to us from OHSU and, among many contributions in medical dermatology, has initiated the first medical continuity clinic for our residents. Other highlights of the past year have been our growth into new basic research labo-ratory space at the University Research Center (photos below) and a dramatic increase in the dermatology research funding.

We are very optimistic that the coming year will continue us on our trajectory of excellence. Our success is rooted in the extraordinary team that has assembled under the banner of UCSD Dermatology but is also fed by the generosity of the community. Gifts to our program are ena-bling us to establish the first pigmented lesion clinic in San Diego with a goal to serve the needs of our community for the care of patients with high-risk for melanoma. Also, gifts and grants to our research program have allowed UCSD Dermatology to become a national leader at the cut-ting edge of a new understanding of the biology of the skin.

Thanks to all who have made our work possible,

Richard L. Gallo, M.D., Ph.D.

WINTER 2010 DIVISION OF DERMATOLOGY NEWSLETTER

VOLUME 4 ISSUE 3

INSIDE THIS ISSUE

MESSAGE FROM THE CHIEF

1

NEW FACULTY & ANNOUNCE-

MENTS

2

RESIDENCY PROGRAM &

GRAND ROUNDS SCHEDULE

3

RECENT PUBLICATIONS

4

DR. TERRY O’GRADY DERMATO-PATHOLOGY LECTURESHIP

7

SUPPORT 8

Derm awards, research UPDATES

5 &

6

University of California, San Diego

Division of Dermatology 200 W. Arbor Drive #8420 San Diego, CA 92103-8420

http://dermatology.ucsd.edu/

Newsletter contact: Paula Rushton

prushton@ucsd.edu 858-822-4608

UCSD DERMATOLOGYUCSD DERMATOLOGYUCSD DERMATOLOGY

NEW FACULTY & NEW ADDITIONS PAGE 2

Robert Lee, M.D. , Ph.D. Dr. Lee joined the Dermatology faculty in September 2009. He is an Assistant Clinical Professor in the Division of Dermatology and Director of Dermatopathology at UCSD.

Dr. Lee received his M.D. and Ph.D. at the UCLA David Geffen School of Medicine and went on to St. Vincent's Catholic Medical Center in Manhattan for his medical internship. He completed his residency in dermatology and fellowship in dermatopathology at the Hospital of the University of Pennsylvania. He further developed his interest in teaching and academic medicine as a Clinician-Educator fellow and Clinical Instructor at Penn.

In addition to medical dermatology and dermatopathology, Dr. Lee's research interest include cutaneous adnexal diseases, tropical dermatology, telemedicine and medical edu-cation.

Dr. Lee's clinical practice is located at the Ambulatory Care Center in Hillcrest and at the Perlman Clinic in La Jolla.

Joseph Lillis, M.D. Dr. Lillis is an Assistant Clinical Professor in the Division of Dermatology at UCSD. He received his M.D. at the Georgetown University School of Medicine in Washington DC. He completed his medical internship with the Legacy Health System and his residency in dermatology at Oregon Health Science University, both in Portland, Oregon.

He further developed his interest in teaching and academic medicine during his third year of residency where he served as chief resident with duties that included involvement in medical student education, organizing resident schedules and organizing the dermatology resident curriculum.

In addition to medical dermatology, Dr. Lillis’ interests include psoriasis, atopic dermati-tis, contact dermatitis and skin disease in acute and chronically immunosuppressed pa-tients.

Dr. Lillis’ clinical practice is located at the Ambulatory Care Center in Hillcrest and at the Perlman Clinic in La Jolla.

Michael R. Lerner, M.D., Ph.D. Dr. Michael Lerner is an Assistant Clinical Professor in the Division of Dermatology. He trained in Dermatology at the University of Texas Southwestern Medical Center and received his MD degree at Yale where he also received his PhD in Molecular Biophysics and Biochemistry. Dr. Lerner completed a medical internship and a postdoctoral fellowship at Washington University in St. Louis.

Dr. Lerner’s clinical practices are located at the Perlman Ambulatory Care Center in La Jolla and the Hillcrest Medical Offices South in San Diego.

Dr. Sharon

Jacob and her husband Dr.

Joseph Soo wel-comed

daughter Raegan Ryan on 12/28/08 and son Rhys Alan on 9/21/09

Front row: Dr. Pristine Lee, Dr. Michelle Jackson, Dr. Elan Newman, Dr. Michelle Nguyen, Dr. Caroline Piggott

Back row: Dr. Gagik Oganesyan, Dr. Shane Hamman, Dr. David Lortscher, Dr. Andrew Krakowski, Dr. Doru Alexandrescu, Dr. Stephan Kempiak

January 2010

21st Navy

28th UCSD “Practical Ap-proaches to Treating Skin of Color” Andrew Alexis, MD,

MPH St. Luke’s Roosevelt Hospital, NYC

February 2010

4th: Navy

11th UCSD “Contact Dermati-tis Review” Daniel Shaw, MD

18th Navy

25th UCSD “Hemangiomas: update from Pediatric Derma-tology” Sheila Friedlander, MD

Rady Children’s Hospital

March 2010

4th: No Grand Rounds

11th UCSD Snakebites” Rich-ard Clark, MD Director, Medi-

cal Toxicology

18th Navy

25th No Grand Rounds

Three residents completed our program in June 2009.

Brook Brouha, MD, PhD

Kiko Gladsjo, MD, PhD

Eugene Huang, MD, PhD

1st year Residents:

Doru Alexandrescu, MD

Shane Hamman, MD

David Lortscher, MD

Michelle Nguyen, MD

2nd year Residents:

Michelle Jackson, MD

Andrew Krakowski, MD

Gagik Oganesyan, MD, PhD

Caroline Piggott, MD

DERMATOLOGY RESIDENCY PROGRAM

PAGE 3 RESIDENCY PROGRAM

3rd year Residents:

Stephan Kempiak, MD, PhD (Chief Resident)

Pristine Lee, MD

Elan Newman, MD

Grand Rounds Schedule Thursdays

8:30—11:30 AM Medical Center/Hillcrest

Sebum Free Fatty Acids Enhance the Innate Immune Defense of Human Sebocytes by Upregulating beta-Defensin-2 Expression. Nakatsuji T, Kao MC, Zhang L, Zouboulis CC, Gallo RL, Huang CM. J Invest Dermatol. 2009 Dec 24.

Commensal bacteria regulate Toll-like receptor 3-dependent inflamma-

tion after skin injury. Lai Y, Di Nardo A, Nakatsuji T, Leichtle A, Yang

Y, Cogen AL, Wu ZR, Hooper LV, Schmidt RR, von Aulock S, Radek

KA, Huang CM, Ryan AF, Gallo RL. Nat Med. 2009 Dec;15(12):1377-

82. Epub 2009 Nov 22.

M1T1 group A streptococcal pili promote epithelial colonization but

diminish systemic virulence through neutrophil extracellular entrap-

ment. Crotty Alexander LE, Maisey HC, Timmer AM, Rooijakkers SH,

Gallo RL, von Köckritz-Blickwede M, Nizet V. J Mol Med. 2009 Dec 4.

[Epub ahead of print]

Fluorescence and UV resonance Raman study of peptide-vesicle interac-

tions of human cathelicidin LL-37 and its F6W and F17W mutants. Ga-

ble JE, Schlamadinger DE, Cogen AL, Gallo RL, Kim JE.

Biochemistry. 2009 Dec 1;48(47):11264-72.

The host defense Peptide cathelicidin is required for NK cell-mediated

suppression of tumor growth. Büchau AS, Morizane S, Trowbridge J,

Schauber J, Kotol P, Bui JD, Gallo RL. J Immunol. 2010 Jan 1;184

(1):369-78. Epub 2009 Nov 30.

Mass spectrometry-based label-free quantitative proteomics. Zhu W, Smith JW, Huang CM. J Biomed Biotechnol. 2010;2010:840518. Epub 2009 Nov 10. Recent development in nano-sized dosage forms of plant alkaloid camp-tothecin-derived drugs. Cuong NV, Hsieh MF, Huang CM. Recent Pat Anticancer Drug Discov. 2009 Nov;4(3):254-61.

Elucidation of the percutaneous absorption of chromium compounds by functional proteomics. Pan TL, Wang PW, Huang CM, Chen CC, Fang JY. Proteomics. 2009 Nov;9(22):5120-31.

Engagement of CD44 by hyaluronan suppresses TLR4 signaling and the

septic response to LPS. Muto J, Yamasaki K, Taylor KR, Gallo RL. Mol

Immunol. 2009 Dec;47(2-3):449-56. Epub 2009 Sep 24.

The antimicrobial activity of liposomal lauric acids against Propionibac-terium acnes. Yang D, Pornpattananangkul D, Nakatsuji T, Chan M, Carson D, Huang CM, Zhang L. Biomaterials. 2009 Oct;30(30):6035-40. Epub 2009 Aug 8.

Antimicrobial peptides and the skin immune defense system. Schauber J,

Gallo RL. J Allergy Clin Immunol. 2009 Sep;124(3 Suppl 2):R13-8.

Filaggrin mutations that confer risk of atopic dermatitis confer greater

risk for eczema herpeticum. Gao PS, Rafaels NM, Hand T, Murray T,

Boguniewicz M, Hata T, Schneider L, Hanifin JM, Gallo RL, Gao L,

Beaty TH, Beck LA, Barnes KC, Leung DY. J Allergy Clin Immunol.

2009 Sep;124(3):507-13, 513.e1-7.

Selective antimicrobial action is provided by phenol-soluble modulins

derived from Staphylococcus epidermidis, a normal resident of the skin.

Cogen AL, Yamasaki K, Sanchez KM, Dorschner RA, Lai Y, MacLeod

DT, Torpey JW, Otto M, Nizet V, Kim JE, Gallo RL. J Invest Derma-

tol. 2010 Jan;130(1):192-200. Epub .

Neutrophil antimicrobial defense against Staphylococcus aureus is medi-

ated by phagolysosomal but not extracellular trap-associated catheli-

cidin. Jann NJ, Schmaler M, Kristian SA, Radek KA, Gallo RL, Nizet V,

Peschel A, Landmann R. J Leukoc Biol. 2009 Nov;86(5):1159-69. Epub

2009 Jul 28.

Phenotype of atopic dermatitis subjects with a history of eczema herpeti-

cum. Beck LA, Boguniewicz M, Hata T, Schneider LC, Hanifin J, Gallo

R, Paller AS, Lieff S, Reese J, Zaccaro D, Milgrom H, Barnes KC,

Leung DY. J Allergy Clin Immunol. 2009 Aug;124(2):260-9, 269.e1-7.

Epub 2009 Jun 27.

Histone H4 is a major component of the antimicrobial action of human

sebocytes. Lee DY, Huang CM, Nakatsuji T, Thiboutot D, Kang SA,

Monestier M, Gallo RL. J Invest Dermatol. 2009 Oct;129(10):2489-96.

Epub 2009 Jun 18.

De novo synthesis of human dermis in vitro in the absence of a three-

dimensional scaffold. Pouyani T, Ronfard V, Scott PG, Dodd CM, Ah-

med A, Gallo RL, Parenteau NL. In Vitro Cell Dev Biol Anim. 2009

Sep;45(8):430-41. Epub 2009 Jun 16.

The molecular pathology of rosacea. Yamasaki K, Gallo RL. J Dermatol

Sci. 2009 Aug;55(2):77-81. Epub 2009 May 29. Review.

Antimicrobial property of lauric acid against Propionibacterium acnes:

its therapeutic potential for inflammatory acne vulgaris. Nakatsuji T,

Kao MC, Fang JY, Zouboulis CC, Zhang L, Gallo RL, Huang CM.

J Invest Dermatol. 2009 Oct;129(10):2480-8. Epub 2009 Apr 23.

Differing effects of exogenous or endogenous cathelicidin on macro-

phage toll-like receptor signaling. Pinheiro da Silva F, Gallo RL, Nizet

V. Immunol Cell Biol. 2009 Aug-Sep;87(6):496-500. Epub 2009 Apr 7.

Profiling human saliva endogenous peptidome via a high throughput MALDI-TOF-TOF mass spectrometry. Huang CM, Zhu W. Comb Chem High Throughput Screen. 2009 Jun;12(5):521-31.

A novel vaccine targeting Fusobacterium nucleatum against abscesses and halitosis. Liu PF, Haake SK, Gallo RL, Huang CM. Vaccine. 2009 Mar 4;27(10):1589-95. Epub 2009 Jan 20.

RECENT PUBLICATIONS Page 4

In December 2009, it was announced that Rady Children's Hospital and UCSD will be awarded one of the American Academy of Dermatology’s (AAD)Gold Triangle Awards for the recent launch of the Eczema Cen-ter and its newly revamped website, www.EczemaCenter.org. The Gold Triangle Awards are conducted annually by the AAD to recognize and honor media, industry, health community and individual efforts that further public understanding of dermatologic conditions and concerns, and encourage healthy behaviors in the care of the skin, hair, and nails. The award will be presented at the AAD's 68th Annual Meeting in Miami on March 5, 2010.

The Eczema Center, located at Rady Children’s Hospital, San Diego, is the nation's first specialty-care facility dedicated to the comprehensive management of atopic dermatitis, known as eczema, and other inflammatory skin conditions. Eczema, which affects up to 20% of children and accounts for an annual cost burden of $1.46 billion in the United States alone, is a chronic and relapsing skin condition characterized by what is known as the “itch-scratch” cycle.

In September of 2008, an interactive “education as intervention” website www.EczemaCenter.org went live. The site, which is free to access, comes complete with an illustrated eczema primer, an innovative PICMED-funded virtual eczema curriculum, and printer-friendly handouts for patients, caregivers, and physicians’ offices. It also acts as the home base for coordinat-ing community-based referrals, ongoing eczema research, and our National Eczema Association-affiliated patient support network. The site itself was programmed to be backwards compatible, meaning that even the most basic computer can still navigate the website and make use of its resources. To date, the website has had more than 100,000 visitors.

In January of 2009, The Eczema Center’s doors opened to wide acclaim. The inaugural event was a free patient and family workshop, including more than 100 interested community members and a subsequent two-day course on pediatric dermatology for practitioners. Patient and caregiver feedback have subsequently led to the commencement of the Eczema School – free educational workshops held in the evenings at the Eczema Center so that patients and families can attend after work. Specific subjects that are covered include a review of eczema’s known pathophysiology; the importance of moisturizing; understanding and utilizing anti-inflammatory therapies; recognizing side-effects of treatments; eczema’s association with allergies; and the course eczema may take over the long-term. The Eczema Center is also the new physical home of the Pediatric Dermatology Research Unit, which coordinates over 30 clinical trials and research studies.

Clinical Trials at UCSD

• Chronic hand eczema

• Plaque psoriasis

• Vitamin D

• Yellow Fever Vaccination

• Eczema Herpeticum registry

• New topical therapy for AD associated pruritus

• Elidel vs. placebo for atopic dermatitis

To find out more contact:

UCSD Dermatology Clinical Trials Unit

Phone: 858.657.7192 ucsddermstudies@gmail.com

www.dermatology.ucsd.edu www.atopicderm.org

Clinical Trials at Rady Children’s

• Eczema

• Mild to Severe Acne

• Psoriasis (biologic)

• Psoriasis (high potency topical steroid in combination with Vitamin D ointment)

• Infantile Hemangioma

• Epidermolysis Bullosa

To find out more contact:

Pediatric & Adolescent Dermatology Research office:

Phone: 858.576.1700 x4295

PAGE 5 DERMATOLOGY RESEARCH UPDATES

Lawrence F. Eichenfield, M.D. Division Chief,

Pediatric & Adolescent Dermatology at Rady Chil-

dren’s Hospital-San Diego & UCSD

UNIVERSITY RESEARCH CENTER

PAGE 6 DERMATOLOGY RESEARCH UPDATES

UCSD Dermatology Research moved into its new location in Sep-tember 2009, just north of the main UCSD campus in La Jolla. The Dermatology labs of Drs. Anna Di Nardo, Chun-Ming Huang, Ben-jamin Yu and Richard Gallo, along with administration and office space combines for more than 6000 square feet.

The URC building is shared with several other UCSD research de-partments including Orthopedic Surgery Research, Pediatrics Dia-betes Research and Reproductive Medicine.

Surface Bacteria Maintains Skin’s Healthy Balance On the skin’s surface, bacteria is abundant, diverse and constant, but inflammation is undesirable. Research in Dermatology at UCSD now shows that the normal bac-teria living on the skin surface trigger a pathway that prevents excessive inflamma-tion after injury.

“These germs are actually good for us,” said Richard L. Gallo, M.D., Ph.D., profes-sor of medicine and pediatrics, chief of UCSD’s Division of Dermatology and the Dermatology section of the Veterans Affairs San Diego Healthcare System.

The study, was recently published in Nature Medicine, and recieved world-wide news attention including: USA Today, BBC News, Daily Mail, Daily Telegraph, New Scientist, Xinhua (China), Sydney Morning Herald, Corriere della Sera (Italy), Hindu (India), CBC (Canada), San Diego Channel 10

“The exciting implications of Dr. Lai’s work is that it provides a molecular basis to under-stand the ‘hygiene hypothesis’ and has uncovered elements of the wound repair response that were previously unknown. This may help us devise new therapeutic approaches for inflammatory skin diseases,” said Gallo.

The so-called "hygiene hypothesis," first introduced in the late 1980s, suggests that a lack of early childhood exposure to in-fectious agents and microorganisms increases an individuals susceptibility to disease by changing how the immune system re-acts to such “bacterial invaders.” The hypothesis was first developed to explain why allergies like hay fever and eczema were less common in children from large families, who were presumably exposed to more infectious agents than others. It is also used to explain the higher incidence of allergic diseases in industrialized countries.

The skin’s normal microflora – the colony microscopic and usually harmless bacteria that live on the skin – includes certain staphylococcal bacterial species that will induce an inflammatory response when present below the skin’s surface, but do not initiate inflammation when present on the epidermis, or outer layer of skin.

In this study, Lai, Gallo and colleagues reveal a previously unknown mechanism by which a product of staphylococci inhibits skin inflammation. Such inhibition is mediated by an acid called staphylococcal lipoteichoic acid (LTA) which acts on kerati-nocytes – the primary cell types found on the epidermis.

The researchers also found that this action is triggered through Toll-like receptor 3(TLR3), activation that is required for normal inflammation after injury.

“Keratinocytes require TLR3 to mount an inflammatory response to injury, responses that are inhibited by staphylococcal LTA,” said Gallo. “To our knowledge, these findings show for the first time that the skin epithelium requires TLR3 for nor-mal inflammation after wounding and that the microflora can modulate these responses.”

Richard Gallo, M.D., Ph.D. and YuPing Lai, Ph.D

The first Dr. Terry O’Grady Dermatopathology Lecture took place Thursday, May 28, 2009. The spe-cial guest lecturer, Dr. Dirk Elston (Geisinger Medi-cal Center) gave the talk “Skin Signs of Systemic Dis-ease” in the Medical Center Auditorium on the Hill-crest UCSD campus.

——————————————————————————————————————

The second Dr. Terry O’Grady Dermatopathology Lecture took place Thursday, September 24, 2009. The special guest lecturer, Dr. Philip LeBoit (UC San Francisco) gave the talk “30 Common Mistakes in Dermatopathology”.

Dr. O’Grady was a faculty member with the UCSD School of Medicine, Division of Dermatology, for 14 years, and served as Residency Program Director since 2004. Dr. O’Grady’s skills as a Dermatopa-thologist and Dermatologist improved the lives of countless patients and his inspired teaching launched many careers. He was a retired Navy captain, an avid surfer and a long-time San Diego Padres season ticket holder. He passed away September 17, 2008, after a brief battle with pancreatic cancer. He was 60 years old.

DR. TERRY O’GRADY DERMATOPATHOLOGY LECTURESHIP

PAGE 7

Dirk Elston, MD, presents “Skin Signs of Systemic Disease”

Dr. Robert W. Goltz, Mrs. Joey O’Grady, guest speaker Dr. Dirk Elston and Dr. Richard Gallo

Dr. Philip LeBoit accepts his award after his lecture.

Platinum Supporters

Johnson and Johnson

SkinMedica

Many of our clinical and research accomplishments are the direct result of the philanthropic support we receive from the community. Your contribution of any size helps us accomplish our mission of teaching, research, and

clinical care.

For additional information on supporting programs in the Division of Dermatology please contact:

Tony Todarello, Director of Development 619.543.5384, or atodarello@ucsd.edu. We are grateful for your consideration.

To make a donation, please make checks payable to: UC San Diego Foundation/Division of Dermatology

Please send to: Tony Todarello, Director of Development

Department of Medicine 200 W. Arbor Drive MC# 8982

San Diego, CA 92103-8982

Support PAGE 8

Dermatology at the University of California, San Diego is committed to providing the highest level of clinical care, research and education for the development of future leaders in dermatology.

Our faculty are experts in their field, and are involved in a wide range of clinical and research endeavors. In par-ticular, UCSD Dermatology is known for our contributions toward a better understanding of inflammatory dis-

eases of the skin and the study of skin disorders affecting children.

We welcome your interest in our Dermatology program and invite you to learn more about us and the UCSD community.