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Fletcher, Kathleen M.

Mayo Clinic

Mayo Clinic

Citations 3

Cutaneous small-vessel vasculitis with predominant IgM or IgG immune deposits on direct immunofluorescence: What does it mean in clinical practice and how does it fit within the dermatologic addendum to the 2012 revised International Chapel Hill Consensus
Fletcher, Kathleen M., Wetter, David A, Lehman, Julia S. , Wetter, David A.

Skin Health and Disease | April 28, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available

10.1093/skinhd/vzag077 Get It

Abstract Cutaneous IgM/IgG immune complex vasculitis is a newly recognized provisional subtype of single-organ vasculitis that is clinically indistinguishable from IgA vasculitis. This retrospective case series evaluated the presence, clinicopathological characteristics and outcomes of patients with IgM and/or IgG dominance or codominance on direct immunofluorescence testing (2010–23). This review represents only the second study to date to characterize this population. Early analysis of 14 patients revealed that cutaneous IgM/IgG immune complex vasculitis was mainly skin limited, and treatment with topical and oral corticosteroids typically resulted in complete resolution without recurrence. Additionally, this study demonstrated that nearly two-thirds (64%) of patients with cutaneous small-vessel vasculitis with IgM and/or IgG dominance or codominance on direct immunofluorescence were ultimately found to have an underlying autoimmune connective tissue disease, cryoglobulinaemia, antineutrophil cytoplasmic antibody-associated vasculitis, infection or a drug-related cause. Therefore, it is imperative that clinicians perform a thorough investigation of this unique population to evaluate for potential underlying diseases and/or triggers.
Report of Hidradenitis Suppurativa in an Individual Affected by Rubinstein‐Taybi Syndrome
Wanberg, Erik J. , Fletcher, Kathleen M., Aghazadeh, Nessa , Aghazadeh Mohandesi, Nessa , Alavi, Afsáneh

Pediatric Dermatology | April 7, 2025 | Volume: 42 | Issue: 4 | Pages: 855-857

10.1111/pde.15906 Get It

ABSTRACTRubinstein‐Taybi syndrome (RTS) is a rare genetic disorder featuring craniofacial abnormalities, intellectual disability, and multi‐organ involvement, including increased risk of keloid formation, pilomatricomas, and hypertrichosis. Hidradenitis suppurativa (HS), a chronic inflammatory skin condition characterized by recurrent abscess formation and draining tunnels, has never been described in a patient affected by RTS. In this report, we detail the history of a 32‐year‐old male with RTS and refractory Hurley stage III HS and discuss the important considerations and risks of managing this unique patient population.
Treatment of pyoderma gangrenosum in pregnancy with certolizumab pegol
Wanberg, Lindsey J , Fletcher, Kathleen M., Alavi, Afsáneh , Alavi, A , Goldfarb, Noah

JEADV Clinical Practice | December 25, 2023 | Volume: 3 | Issue: 2 | Pages: 696-698

10.1002/jvc2.346 Get It

AbstractWe report a case of a 41‐year‐old woman who developed pregnancy‐associated pyoderma gangrenosum (PG) at 4 weeks gestation. She was initially treated with prednisone, however, due to lack of improvement and risk of systemic corticosteroids in pregnancy, underwent a prednisone taper and was initiated on certolizumab pegol (CZP). The patient experienced complete wound re‐epithelialization 1 month after CZP initiation. She had no pregnancy complications except for prednisone‐associated gestational diabetes and gave birth to a healthy baby. CZP is a tumour necrosis factor‐inhibitor with negligible placental transfer and no known adverse effects in pregnancy. Its efficacy and safety for autoinflammatory dermatoses in pregnancy are very promising. This is the first case to report CZP treatment for PG in a pregnant patient.