Through the Dermatology Consultation Service at the NIH Clinical Center, patients with a variety of rare diseases with cutaneous manifestations are evaluated. In addition, patients who experience adverse reactions to experimental therapeutic agents or manifest unrelated skin conditions while at the NIH are assessed and treated. We provide training to Dermatology Branch clinical fellows, fellows from other NIH Institutes, and visiting dermatology residents from around the country. 'Grand Rounds at the NIH', an ongoing feature published in the Journal of the American Academy of Dermatology, selects and highlights interesting cases that we have evaluated.

Dr. Cowen's primary research interest involves chronic graft-versus-host disease (cGVHD) and autoinflammatory diseases. He is Co-Study Chair of a multi-disciplinary NIH initiative aimed at the study and treatment of cGVHD (04-C-0281) and Principal Investigator of a therapeutic study of topical ruxolitinib for cutaneous cGVHD (18-AR-0035).


Former Lab Members

Clinical Fellows

  • Rachel Rosenstein, M.D., Ph.D.
  • Dominique Pichard, M.D., M.H.Sc.

Medical Students

  • Suzanne Ward, M.D. (Dermatology)
  • Rena Zuo, M.D. (Dermatology)
  • Kathryn Martires, M.D. (Dermatology)
  • Asha Patel, M.D. (Dermatology)

Clinical Trials

ClinicalTrials.gov Identifier: NCT00001506

This is a training, natural history of disease, and screening protocol for the evaluation, treatment and follow-up of patients with dermatologic diseases and systemic diseases with cutaneous manifestations. This protocol was developed to allow subject enrollment for teaching purposes and to allow for second opinions regarding relatively complicated patients, and to allow for evaluation of non-invasive tools for the diagnosis and monitoring of cutaneous manifestations. 

Scientific Publications

Selected Recent Publications

Identification of Fibroinflammatory and Fibrotic Transcriptomic Subsets of Human Cutaneous Sclerotic Chronic Graft-Versus-Host Disease.

Rosenstein RK, Rose JJ, Brooks SR, Tsai WL, Gadina M, Pavletic SZ, Nagao K, Cowen EW
JID Innov.
2024 Mar;
doi: 10.1016/j.xjidi.2023.100246
PMID: 38357212

Host-Pathogen Interactions in Human Polyomavirus 7‒Associated Pruritic Skin Eruption.

Rosenstein RK, Pastrana DV, Starrett GJ, Sapio MR, Hill NT, Jo JH, Lee CR, Iadarola MJ, Buck CB, Kong HH, Brownell I, Cowen EW
J Invest Dermatol.
2021 May;
doi: 10.1016/j.jid.2020.09.014
PMID: 33075349

Quality of Life in Patients With Skin of Color and Chronic Graft-vs-Host Disease.

Smith ZI, Rosenstein RK, Banerjee S, Pichard DC, Pavletic SZ, Cowen EW
JAMA Dermatol.
2020 May 1;
doi: 10.1001/jamadermatol.2019.4857
PMID: 32049308

Rehabilitation Interventions in the Multidisciplinary Management of Patients With Sclerotic Graft-Versus-Host Disease of the Skin and Fascia.

Molés-Poveda P, Comis LE, Joe GO, Mitchell SA, Pichard DC, Rosenstein RK, Solomon B, Pavletic SZ, Cowen EW
Arch Phys Med Rehabil.
2021 Apr;
doi: 10.1016/j.apmr.2020.10.141
PMID: 33347890

Distribution and Functional Consequences of Somatic MAP2K1 Variants in Affected Skin Associated with Bone Lesions in Melorheostosis.

Jha S, Ivovic A, Kang H, Meylan F, Hanson EP, Rimland C, Lange E, Katz J, McBride A, Warner AC, Edmondson EF, Cowen EW, Marini JC, Siegel RM, Bhattacharyya T
J Invest Dermatol.
2021 Mar;
doi: 10.1016/j.jid.2020.06.036
PMID: 32791068

Calcinosis Cutis in the Setting of Chronic Skin Graft-Versus-Host Disease.

Saardi KM, Rosenstein RK, Anadkat MJ, Micheletti RG, Schiffenbauer AI, Pavletic SZ, Cowen EW
JAMA Dermatol.
2020 Jul 1;
doi: 10.1001/jamadermatol.2020.1157
PMID: 32432645

Voriconazole and the Risk of Keratinocyte Carcinomas Among Lung Transplant Recipients in the United States.

D'Arcy ME, Pfeiffer RM, Rivera DR, Hess GP, Cahoon EK, Arron ST, Brownell I, Cowen EW, Israni AK, Triplette MA, Yanik EL, Engels EA
JAMA Dermatol.
2020 Jul 1;
doi: 10.1001/jamadermatol.2020.1141
PMID: 32401271

Key Publications

Janus kinase (JAK) inhibition with baricitinib in refractory juvenile dermatomyositis.

Kim H, Dill S, O'Brien M, Vian L, Li X, Manukyan M, Jain M, Adeojo LW, George J, Perez M, Grom AA, Sutter M, Feldman BM, Yao L, Millwood M, Brundidge A, Pichard DC, Cowen EW, Shi Y, Lu S, Tsai WL, Gadina M, Rider LG, Colbert RA
Ann Rheum Dis.
2020 Aug 25;
pii: annrheumdis-2020-218690. doi: 10.1136/annrheumdis-2020-218690
PMID: 32843325

Graft-versus-host disease: part I. Pathogenesis and clinical manifestations of graft-versus-host disease.

Hymes SR, Alousi AM, Cowen EW
J Am Acad Dermatol.
2012 Apr;
doi: 10.1016/j.jaad.2011.11.960
PMID: 22421123

Sclerotic-type chronic GVHD of the skin: clinical risk factors, laboratory markers, and burden of disease.

Martires KJ, Baird K, Steinberg SM, Grkovic L, Joe GO, Williams KM, Mitchell SA, Datiles M, Hakim FT, Pavletic SZ, Cowen EW
2011 Oct 13;
doi: 10.1182/blood-2011-04-350249
PMID: 21791415

Chronic phototoxicity and aggressive squamous cell carcinoma of the skin in children and adults during treatment with voriconazole.

Cowen EW, Nguyen JC, Miller DD, McShane D, Arron ST, Prose NS, Turner ML, Fox LP
J Am Acad Dermatol.
2010 Jan;
doi: 10.1016/j.jaad.2009.09.033
PMID: 19896749

An autoinflammatory disease with deficiency of the interleukin-1-receptor antagonist.

Aksentijevich I, Masters SL, Ferguson PJ, Dancey P, Frenkel J, van Royen-Kerkhoff A, Laxer R, Tedgård U, Cowen EW, Pham TH, Booty M, Estes JD, Sandler NG, Plass N, Stone DL, Turner ML, Hill S, Butman JA, Schneider R, Babyn P, El-Shanti HI, Pope E, Barron K, Bing X, Laurence A, Lee CC, Chapelle D, Clarke GI, Ohson K, Nicholson M, Gadina M, Yang B, Korman BD, Gregersen PK, van Hagen PM, Hak AE, Huizing M, Rahman P, Douek DC, Remmers EF, Kastner DL, Goldbach-Mansky R
N Engl J Med.
2009 Jun 4;
doi: 10.1056/NEJMoa0807865
PMID: 19494218

Measuring therapeutic response in chronic graft-versus-host disease: National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: IV. Response Criteria Working Group report.

Pavletic SZ, Martin P, Lee SJ, Mitchell S, Jacobsohn D, Cowen EW, Turner ML, Akpek G, Gilman A, McDonald G, Schubert M, Berger A, Bross P, Chien JW, Couriel D, Dunn JP, Fall-Dickson J, Farrell A, Flowers ME, Greinix H, Hirschfeld S, Gerber L, Kim S, Knobler R, Lachenbruch PA, Miller FW, Mittleman B, Papadopoulos E, Parsons SK, Przepiorka D, Robinson M, Ward M, Reeve B, Rider LG, Shulman H, Schultz KR, Weisdorf D, Vogelsang GB, Response Criteria Working Group.
Biol Blood Marrow Transplant.
2006 Mar;