ORCID Profile
0000-0002-9263-3889
Current Organisations
The Kinghorn Cancer Centre
,
University of New South Wales
,
Liverpool Hospital
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: IOP Publishing
Date: 04-04-2013
Publisher: Wiley
Date: 27-03-2023
DOI: 10.1111/AJD.14025
Abstract: Academic dermatologists in Australia and New Zealand provide high‐quality and meaningful contributions to the understanding of disease and therapeutic translational research. Concerns have been raised by the Australian Medical Association regarding the decline of clinical academics in Australia as a whole, however, such trends in scholarly output have not previously been analysed for Australasian dermatologists. A bibliometric analysis of dermatologists in Australia and New Zealand was conducted in January and February 2023. Available Scopus profiles for all dermatologists were used to measure lifetime H index, scholarly output, citation counts and field‐weighted citation impact (FWCI) in the last 5 years (2017–2022). Trends in output over time were measured using non‐parametric tests. Differences in output between subgroups stratified by gender and academic leadership positions (associate professor or professor) were measured using Wilcoxon rank‐sum and one‐way ANOVA tests. The scholarly output of recent College graduates was also analysed as a subgroup, comparing the same bibliographic variables in the 5 years preceding and 5 years following awarding of their fellowships. From the 463 practising dermatologists in Australia and New Zealand, 372 (80%) were successfully matched to Scopus researcher profiles. Of these dermatologists, 167 were male (45%) and 205 (55%) were female, and 31 (8%) held academic leadership positions. Most dermatologists (67%) published at least one paper in the last 5 years. The median lifetime H index was 4, and between 2017 and 2022 median scholarly output was 3, the median citations were 14 and the median FWCI was 0.64. There was a non‐significant trend towards fewer publications per year, however, citation count and FWCI decreased significantly. By subgroups, female dermatologists published significantly more papers between 2017 and 2022, and other bibliographic variables were comparable to male dermatologists. However, women were underrepresented in positions of academic leadership—comprising only 32% of this cohort despite representing 55% of dermatologists. Professors were also significantly more likely to have higher bibliographic outcomes than associate professors. Finally, analysis of recent College graduates highlighted a significant decline in bibliometric outcomes pre‐ and post‐fellowship. Overall, our analysis identifies a trend towards decreased research output by dermatologists in Australia and New Zealand in the last 5 years. Strategies to support dermatologists in research endeavours, particularly women and recent graduates, will be essential in maintaining strong scholarly output among Australasian dermatologists and thereby sustaining optimal evidence‐based patient care.
Publisher: Wiley
Date: 17-08-2021
Publisher: Springer Science and Business Media LLC
Date: 29-03-2023
DOI: 10.1007/S11912-023-01385-6
Abstract: In the preceding decade, the management of metastatic cutaneous melanoma has been revolutionised with the development of highly effective therapies including immune checkpoint inhibitors (specifically CTLA-4 and PD-1 inhibitors) and targeted therapies (BRAF and MEK inhibitors). The role of chemotherapy in the contemporary management of melanoma is undefined. Extended analyses highlight substantially improved 5-year survival rates of approximately 50% in patients with metastatic melanoma treated with first-line therapies. However, most patients will progress on these first-line treatments. Sequencing of chemotherapy following failure of targeted and immunotherapies is associated with low objective response rates and short progression-free survival, and thus, meaningful benefits to patients are minimal. Chemotherapy has limited utility in the contemporary management of cutaneous melanoma (with a few exceptions, discussed herein) and should not be the standard treatment sequence following failure of first-line therapies. Instead, enrolment onto clinical trials should be standard-of-care in these patients.
Publisher: Wiley
Date: 20-05-2023
DOI: 10.1111/JDV.19179
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 18-05-2023
DOI: 10.1097/CMR.0000000000000900
Abstract: Metastatic uveal melanoma (mUM) has historically been associated with short survival and limited effective treatments. Immune checkpoint inhibitors (ICIs) have been trialed in mUM however, robust conclusions regarding their efficacy are difficult to draw given small study sizes and heterogeneous patient populations. Five databases were searched using a combination of ‘ICI’ and ‘mUM’ headings, and data on patient demographics, objective response rate (ORR), overall survival (OS) and progression-free survival (PFS) were extracted. Pooled ORR was calculated using a random effects model and the inverse variance method. Available Kaplan–Meier OS and PFS curves were used to construct summary OS and PFS plots, from which median values were derived. Pooled ORR was 9.2% overall (95% CI 7.2–11.8) [4.1% for anti-CTLA4 (95% CI 2.1–7.7), 7.1% for anti-PD(L)1 (95% CI 4.5–10.9) and 13.5% for anti-CTLA4 plus anti-PD1 (95% CI 10.0–18.0)]. Median OS was 11.5 months overall (95% CI 9.5–13.8) [8.0 months for anti-CTLA4 (95% CI 5.5–9.9), 11.7 months for anti-PD(L)1 (95% CI 9.0–14.0) and 16.0 months for ipilimumab plus anti-PD1 (95% CI 11.5–17.7) ( P 0.001)]. Median PFS was 3.0 months overall (95% CI 2.9–3.1). ICIs have limited efficacy in mUM and a recommendation for their use must consider the balance of benefit and risk for in idual patients if no other options are available. Further biomarker profiling studies may be helpful in assessing which patients will benefit from ICIs, in particular the addition of ipilimumab to anti-PD1 therapy.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Wiley
Date: 12-07-2022
DOI: 10.1111/JDV.18403
Publisher: Elsevier BV
Date: 06-2014
Publisher: Elsevier BV
Date: 09-2021
Publisher: Wiley
Date: 20-10-2021
DOI: 10.1002/SKI2.71
Abstract: Sarcoidosis is a non‐infective granulomatous disorder of unknown aetiology, with cutaneous involvement affecting up to 30% of patients. Drug‐induced sarcoidosis has been reported secondary to modern melanoma therapies including immune‐checkpoint inhibitors and first generation BRAF inhibitors such as vemurafenib and dabrafenib. Herein, we report a case of cutaneous micropapular sarcoidosis that first developed on immune‐checkpoint inhibition with ipilimumab and nivolumab for metastatic melanoma, which was exacerbated and further complicated by pityriasis rubra pilaris‐like palmar plaques upon transition to a next‐generation BRAF‐dimerisation inhibitor. Both the micropapular eruption and palmar plaques rapidly resolved after cessation of the novel BRAF‐inhibitor and concurrent commencement of hydroxychloroquine. It is unclear how inhibition of BRAF‐dimerisation results in granuloma formation, though upregulation of T H 1/T H 17 T‐cells and impairment of T‐reg cells may be responsible. Clinicians should be aware of the potential for exacerbation of sarcoidosis when transitioning from immune‐checkpoint inhibitors to these novel BRAF‐dimerisation inhibitors, particularly as their uptake in treating cancers increases beyond clinical trials. Further studies are required to assess whether these next‐generation agents can trigger sarcoidosis de‐novo, or simply exacerbate pre‐existing sarcoidosis.
Publisher: Wiley
Date: 21-10-2023
DOI: 10.1111/JDV.18649
Publisher: Wiley
Date: 30-07-2022
DOI: 10.1002/RCR2.1010
Abstract: Disseminated primary varicella infection can carry risks of significant morbidity and mortality particularly in immunocompromised populations. Routine, funded childhood vaccination against varicella has significantly reduced associated hospitalization and deaths, however, uptake and efficacy among adults is unknown. We present a case of disseminated primary varicella infection (including rash, pneumonitis, hepatitis and thrombocytopenia) in an immunocompetent patient on long term inhaled corticosteroids for asthma. This case highlights potential risk factors for severe varicella which require further study in adults and raises the need to discuss vaccination in at risk groups including appropriate counselling in those who may be at higher risk.
Publisher: Oxford University Press (OUP)
Date: 21-08-2023
DOI: 10.1093/BJD/LJAD303
Abstract: Resident memory T-cells (T-RMs) remain in epithelial barrier tissues after antigen exposure and the initial effector phase. These T-RMs provide effective antimicrobial and anticancer immunity, however pathogenic T-RMs have been shown to mediate various chronic inflammatory disorders in a variety of tissue types. In the skin, T-RMs are referred to as resident cutaneous memory T-cells (cT-RMs). Understanding the mechanisms leading to the development and establishment of these cT-RMs populations may allow for targeted treatments providing durable responses in chronic immune-mediated skin diseases, even after cessation. In this Review, we summarise the evidence on cT-RMs as drivers of chronic inflammatory dermatoses including psoriasis, vitiligo, atopic dermatitis, cutaneous lupus erythematosus and alopecia areata, among others. Data from in-vitro, animal model, and ex-vivo human studies are presented – with a focus on the potential for cT-RMs to trigger acute disease flares as well as recurrent disease by establishing an immune ‘memory’ in the skin. Furthermore, available data on the potential for existing and novel treatments to affect the development or survival of cT-RMs in the skin are synthesised. These suggest a dynamic and rapidly growing area in the field of dermatology however we also discuss areas in need of greater research to allow for optimal treatment selection for long-term disease control.
Publisher: Wiley
Date: 21-09-2022
DOI: 10.1111/AJD.13925
Publisher: Wiley
Date: 16-02-2023
Abstract: Rheumatoid arthritis (RA) may predispose patients to opportunistic infections—either from innate immune dysregulation, or as a result of immunosuppressant use to treat the RA. Particularly concerning opportunistic infections are those caused by non‐tuberculous mycobacterial (NTM) organisms, the incidence of which has been increasing in epidemiological studies. Despite this, guidelines on the management of patients with RA who develop NTM infections are scarce, particularly with respect to immunosuppressant regimen modulation and duration of antibiotic therapy. Herein, we present a case of disseminated Mycobacterium chelonae infection, manifesting as arthralgia and cutaneous nodules. In addition, a review of the literature was conducted to Preferred Reporting Items for Systemic Reviews and Meta‐Analyses guidelines to identify similar cases in the literature—revealing that all RA‐associated M. Chelonae infections occurred in immunosuppressed patients (the majority with corticosteroids or tumor necrosis factor inhibitors), and considerable heterogeneity in management approaches. Further research regarding risk factors, preventative approaches and best management of such NTM infections in vulnerable patients with RA is required in order to establish consensus guidelines and consistency.
Publisher: Wiley
Date: 20-12-2022
DOI: 10.1111/AJD.13776
Publisher: Copernicus GmbH
Date: 28-03-2022
DOI: 10.5194/EGUSPHERE-EGU22-10625
Abstract: & & The Amazon River basin contains a substantial amount of carbon stored within terrestrial ecosystems. The unknown fate of this this carbon remains a substantial source of uncertainty in projections of the Earth system. While increasing atmospheric carbon dioxide concentrations could potentially enhance photosynthetic carbon uptake and/or reduce transpiration, increasing vapor pressure deficits have the potential to act with the opposite sign on both of these fluxes. Here, we investigate these competing factors at a process level, using a data assimilation system in which we constrain a parsimonious ecosystem model with observations from river runoff gauging stations, gravimetric water storage anomalies, and solar-induced chlorophyll fluorescence. Our model-data fusion provides us with an observationally consistent reanalysis of 21st-century ecohydrology across 14 Amazon watersheds along side the posterior distribution of key process parameters and emergent ecosystem properties such as water use efficiency (WUE). We find that the response to trends in atmospheric carbon dioxide concentrations and meteorological drivers varies across a hydroclimatic gradient within the Amazon, with implications for how carbon and water cycling could be expected to change subject to future biogeochemical and climatic trends.& &
Publisher: Wiley
Date: 20-02-2023
DOI: 10.1111/AJD.14009
Publisher: Wiley
Date: 05-05-2022
DOI: 10.1111/AJD.13866
Publisher: Elsevier BV
Date: 10-2013
Publisher: Elsevier BV
Date: 08-2023
No related grants have been discovered for James Pham.