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INFORMATION FOR

Shawn Cowper, MD

Professor of Dermatology

Contact Information

Shawn Cowper, MD

Office Location

Mailing Address

  • Dermatology

    PO Box 208059

    New Haven, CT 06520-8059

    United States

Research Summary

Nephrogenic systemic fibrosis (NSF) is a disease marked by skin stiffening in the setting of a patient with kidney disease. The disease has been linked with MRI Contrast Agents. There is no evidence to suggest that patients without kidney disease can develop NSF.

Our laboratory investigates cases of possible NSF (examining clinical records and tissue slides) to try to confirm the diagnosis. Once confirmed, we interview patients, conduct an investigation into medical records, and use the information to populate a database comparing all known patients with NSF verified in our laboratory. We use this information to guide medical, pharmaceutical, and government advisory personnel, and to guide further research into the cause of this mysterious disorder.

Our goal is to eradicate this dangerous (and sometimes deadly) condition, and to use the information to better understand fibrosis and wound healing in the hopes of impacting research on related conditions.

Specialized Terms: Alopecia; Cutaneous lymphoma; Pathology informatics; Nephrogenic fibrosing dermopathy; Nephrogenic systemic fibrosis

Extensive Research Description

My primary research interest is in the mechanism of nephrogenic systemic fibrosis (formerly nephrogenic fibrosing dermopathy). This is an emerging fibrosing disorder seen in patients with renal disease. Compelling epidemiological, microanalytical, and animal studies have linked the disease to the use of gadolinium-based contrast agents (GBCA) used in MRI imaging. Current thinking suggests these renally-excreted compounds are ineffectively removed in the renally-impaired, leading to a novel toxicity reaction. The findings manifest themselves most dramatically in the skin and soft-tissue of affected patients by increased production of matrix elements (collagen, elastin, mucin). These excess components reduce the flexibility and compliance of skin, leading to decreased range of motion in affected limbs. Questions currently being examined include effects in non-cutaneous tissues and factors that may contribute to a propensity to develop NSF (genetic, medical cofactors, other toxicities, etc).
Yale is home to the International NSF Registry, housing clinical records and pathology specimens from over 330 patients with NSF. This registry serves as a source of basic information for investigations into the clinical and histological aspects of NSF.



Yale is also the home base for a core of interested clinical and basic science researchers actively engaged in understanding all aspects of this unusual disease. Periodically, this team hosts the Yale Fibrosis Symposium.



Besides NSF, I am interested in cutaneous lymphomas and alopecias, and the appropriate use of histopathology in diagnosing these disorders.



My primary and preferred instructional tool is the networked computer. I have been involved with web-based pathology education for some time. My largest project Pathmax, was one of the first web-based resource for pathology professionals on the internet. Beginning in 1997, this site ran continuously until 2018. I am also one of the cofounders of the Dermatopathology Master Class Series, a web-based streaming lecture series on topics of relevance in dermatopathology. In recent years I have been the chairman of the Virtual Slide Library of the American Society of Dermatopathology where I manage 50 volunteers interested in optimizing and vetting over 10,000 scanned dermatopathology whole slide images.

Coauthors

Research Interests

Alopecia; Dermatology; Fibrosis; Medical Informatics; Pathology; Nephrogenic Fibrosing Dermopathy

Research Images

Selected Publications

  • Draining nodules on the buttocks: A Brazilian butt lift gone wrongLittle A, Cowper S, Ramachandran S. Draining nodules on the buttocks: A Brazilian butt lift gone wrong International Journal Of Women's Dermatology 2019, 5: 194-195. DOI: 10.1016/j.ijwd.2019.04.004.
  • 168 Nephrogenic systemic fibrosisGalan A, Cowper S. 168 Nephrogenic systemic fibrosis 2018, 557-558. DOI: 10.1016/b978-0-7020-6912-3.00168-3.
  • Cutaneous Fibrosis and Normal Wound HealingHamburg-Shields E, Myung P, Cowper S. Cutaneous Fibrosis and Normal Wound Healing 2017, 577-600. DOI: 10.1007/978-3-319-29785-9_32.
  • Nephrogenic Systemic FibrosisLaChance A, Abu-Alfa A, Cowper S. Nephrogenic Systemic Fibrosis 2015, 119-136. DOI: 10.1007/978-1-4939-2395-3_12.
  • - Senescent alopecia (“senile alopecia” or “senescent balding”)Sperling L, Cowper S, Knopp E. - Senescent alopecia (“senile alopecia” or “senescent balding”) 2012, 49-50. DOI: 10.3109/9781841847344-10.
  • - Androgenetic alopeciaSperling L, Cowper S, Knopp E. - Androgenetic alopecia 2012, 51-61. DOI: 10.3109/9781841847344-11.
  • - Telogen effluviumSperling L, Cowper S, Knopp E. - Telogen effluvium 2012, 62-68. DOI: 10.3109/9781841847344-12.
  • - TrichotillomaniaSperling L, Cowper S, Knopp E. - Trichotillomania 2012, 69-75. DOI: 10.3109/9781841847344-13.
  • - Traction alopeciaSperling L, Cowper S, Knopp E. - Traction alopecia 2012, 76-80. DOI: 10.3109/9781841847344-14.
  • - Postoperative (pressure-induced) alopeciaSperling L, Cowper S, Knopp E. - Postoperative (pressure-induced) alopecia 2012, 81-83. DOI: 10.3109/9781841847344-15.
  • - Temporal triangular alopeciaSperling L, Cowper S, Knopp E. - Temporal triangular alopecia 2012, 84-87. DOI: 10.3109/9781841847344-16.
  • - Alopecia areataSperling L, Cowper S, Knopp E. - Alopecia areata 2012, 88-104. DOI: 10.3109/9781841847344-17.
  • - Psoriatic alopeciaSperling L, Cowper S, Knopp E. - Psoriatic alopecia 2012, 105-110. DOI: 10.3109/9781841847344-18.
  • - Tumor necrosis factor-alpha inhibitor associated psoriasiform alopecia (drug-induced psoriasiform alopecia)Sperling L, Cowper S, Knopp E. - Tumor necrosis factor-alpha inhibitor associated psoriasiform alopecia (drug-induced psoriasiform alopecia) 2012, 111-116. DOI: 10.3109/9781841847344-19.
  • - Syphilitic alopeciaSperling L, Cowper S, Knopp E. - Syphilitic alopecia 2012, 117-119. DOI: 10.3109/9781841847344-20.
  • - Noncicatricial alopecia from systemic lupus erythematosusSperling L, Cowper S, Knopp E. - Noncicatricial alopecia from systemic lupus erythematosus 2012, 120-123. DOI: 10.3109/9781841847344-21.
  • - Loose anagen hair syndromeSperling L, Cowper S, Knopp E. - Loose anagen hair syndrome 2012, 124-128. DOI: 10.3109/9781841847344-22.
  • - Central, centrifugal, cicatricial alopeciaSperling L, Cowper S, Knopp E. - Central, centrifugal, cicatricial alopecia 2012, 129-134. DOI: 10.3109/9781841847344-23.
  • Acne keloidis (folliculitis keloidalis)Sperling L, Cowper S, Knopp E. Acne keloidis (folliculitis keloidalis) 2012, 135-139. DOI: 10.3109/9781841847344-24.
  • - Folliculitis decalvansSperling L, Cowper S, Knopp E. - Folliculitis decalvans 2012, 140-142. DOI: 10.3109/9781841847344-25.
  • - Tufted folliculitisSperling L, Cowper S, Knopp E. - Tufted folliculitis 2012, 143-145. DOI: 10.3109/9781841847344-26.
  • - Lichen planopilarisSperling L, Cowper S, Knopp E. - Lichen planopilaris 2012, 146-158. DOI: 10.3109/9781841847344-27.
  • - Frontal fibrosing alopeciaSperling L, Cowper S, Knopp E. - Frontal fibrosing alopecia 2012, 159-162. DOI: 10.3109/9781841847344-28.
  • - Fibrosing alopecia in a pattern distributionSperling L, Cowper S, Knopp E. - Fibrosing alopecia in a pattern distribution 2012, 163-166. DOI: 10.3109/9781841847344-29.
  • - Using this bookSperling L, Cowper S, Knopp E. - Using this book 2012, 10-11. DOI: 10.3109/9781841847344-3.
  • - Chronic cutaneous lupus erythematosusSperling L, Cowper S, Knopp E. - Chronic cutaneous lupus erythematosus 2012, 167-174. DOI: 10.3109/9781841847344-30.
  • - Dissecting cellulitis of the scalp (perifolliculitis capitis abscedens et suffodiens)Sperling L, Cowper S, Knopp E. - Dissecting cellulitis of the scalp (perifolliculitis capitis abscedens et suffodiens) 2012, 175-179. DOI: 10.3109/9781841847344-31.
  • - Erosive pustular dermatosisSperling L, Cowper S, Knopp E. - Erosive pustular dermatosis 2012, 180-182. DOI: 10.3109/9781841847344-32.
  • - Brocq’s alopecia (pseudopelade of Brocq) and end-stage cicatricial alopeciaSperling L, Cowper S, Knopp E. - Brocq’s alopecia (pseudopelade of Brocq) and end-stage cicatricial alopecia 2012, 183-186. DOI: 10.3109/9781841847344-33.
  • - Aplasia cutis congenita of the scalpSperling L, Cowper S, Knopp E. - Aplasia cutis congenita of the scalp 2012, 187-189. DOI: 10.3109/9781841847344-34.
  • - Tinea capitisSperling L, Cowper S, Knopp E. - Tinea capitis 2012, 190-198. DOI: 10.3109/9781841847344-35.
  • - Trichodysplasia of immunosuppressionSperling L, Cowper S, Knopp E. - Trichodysplasia of immunosuppression 2012, 199-202. DOI: 10.3109/9781841847344-36.
  • - Chemotherapy-induced alopeciaSperling L, Cowper S, Knopp E. - Chemotherapy-induced alopecia 2012, 203-206. DOI: 10.3109/9781841847344-37.
  • - Overview of hair shaft disordersSperling L, Cowper S, Knopp E. - Overview of hair shaft disorders 2012, 207-217. DOI: 10.3109/9781841847344-38.
  • - Specimen acquisition, handling and processingSperling L, Cowper S, Knopp E. - Specimen acquisition, handling and processing 2012, 12-13. DOI: 10.3109/9781841847344-4.
  • - Normal hair anatomy and architectureSperling L, Cowper S, Knopp E. - Normal hair anatomy and architecture 2012, 14-25. DOI: 10.3109/9781841847344-5.
  • - Evaluating and describing transverse (horizontal) sectionsSperling L, Cowper S, Knopp E. - Evaluating and describing transverse (horizontal) sections 2012, 26-34. DOI: 10.3109/9781841847344-6.
  • - Classification of hair diseaseSperling L, Cowper S, Knopp E. - Classification of hair disease 2012, 35-36. DOI: 10.3109/9781841847344-7.
  • - Distinctive or critical histological features and associated diseasesSperling L, Cowper S, Knopp E. - Distinctive or critical histological features and associated diseases 2012, 37-43. DOI: 10.3109/9781841847344-8.
  • - Clinical correlationSperling L, Cowper S, Knopp E. - Clinical correlation 2012, 44-48. DOI: 10.3109/9781841847344-9.
  • Using this bookSperling L, Cowper S, Knopp E. Using this book 2012, 1-2. DOI: 10.3109/9780203490662.001.
  • Distinctive or critical histological features and associated diseasesSperling L, Cowper S, Knopp E. Distinctive or critical histological features and associated diseases 2012, 28-34. DOI: 10.3109/9780203490662.006.
  • Noncicatricial alopecia from systemic lupus erythematosusSperling L, Cowper S, Knopp E. Noncicatricial alopecia from systemic lupus erythematosus 2012, 111-114. DOI: 10.3109/9780203490662.019.
  • Loose anagen hair syndromeSperling L, Cowper S, Knopp E. Loose anagen hair syndrome 2012, 115-119. DOI: 10.3109/9780203490662.020.
  • Central, centrifugal, cicatricial alopeciaSperling L, Cowper S, Knopp E. Central, centrifugal, cicatricial alopecia 2012, 120-125. DOI: 10.3109/9780203490662.021.
  • Acne keloidalis (folliculitis keloidalis)Sperling L, Cowper S, Knopp E. Acne keloidalis (folliculitis keloidalis) 2012, 126-130. DOI: 10.3109/9780203490662.022.
  • Folliculitis decalvansSperling L, Cowper S, Knopp E. Folliculitis decalvans 2012, 131-133. DOI: 10.3109/9780203490662.023.
  • Tufted folliculitisSperling L, Cowper S, Knopp E. Tufted folliculitis 2012, 134-136. DOI: 10.3109/9780203490662.024.
  • Lichen planopilarisSperling L, Cowper S, Knopp E. Lichen planopilaris 2012, 137-149. DOI: 10.3109/9780203490662.025.
  • Frontal fibrosing alopeciaSperling L, Cowper S, Knopp E. Frontal fibrosing alopecia 2012, 150-153. DOI: 10.3109/9780203490662.026.
  • Fibrosing alopecia in a pattern distributionSperling L, Cowper S, Knopp E. Fibrosing alopecia in a pattern distribution 2012, 154-157. DOI: 10.3109/9780203490662.027.
  • Chronic cutaneous lupus erythematosusSperling L, Cowper S, Knopp E. Chronic cutaneous lupus erythematosus 2012, 158-165. DOI: 10.3109/9780203490662.028.
  • Classification of hair diseaseSperling L, Cowper S, Knopp E. Classification of hair disease 2012, 26-27. DOI: 10.3109/9780203490662.005.
  • Clinical correlationSperling L, Cowper S, Knopp E. Clinical correlation 2012, 35-39. DOI: 10.3109/9780203490662.007.
  • Specimen acquisition, handling and processingSperling L, Cowper S, Knopp E. Specimen acquisition, handling and processing 2012, 3-4. DOI: 10.3109/9780203490662.002.
  • Normal Hair Anatomy and ArchitectureSperling L, Cowper S, Knopp E. Normal Hair Anatomy and Architecture 2012, 5-16. DOI: 10.3109/9780203490662.003.
  • Evaluating and Describing Transverse (Horizontal) SectionsSperling L, Cowper S, Knopp E. Evaluating and Describing Transverse (Horizontal) Sections 2012, 17-25. DOI: 10.3109/9780203490662.004.
  • Senescent alopecia (“senile alopecia” or “senescent balding”)Sperling L, Cowper S, Knopp E. Senescent alopecia (“senile alopecia” or “senescent balding”) 2012, 40-41. DOI: 10.3109/9780203490662.008.
  • Androgenetic alopeciaSperling L, Cowper S, Knopp E. Androgenetic alopecia 2012, 42-52. DOI: 10.3109/9780203490662.009.
  • Telogen effluviumSperling L, Cowper S, Knopp E. Telogen effluvium 2012, 53-59. DOI: 10.3109/9780203490662.010.
  • TrichotillomaniaSperling L, Cowper S, Knopp E. Trichotillomania 2012, 60-66. DOI: 10.3109/9780203490662.011.
  • Traction alopeciaSperling L, Cowper S, Knopp E. Traction alopecia 2012, 67-71. DOI: 10.3109/9780203490662.012.
  • Postoperative (pressure-induced) alopeciaSperling L, Cowper S, Knopp E. Postoperative (pressure-induced) alopecia 2012, 72-74. DOI: 10.3109/9780203490662.013.
  • Temporal triangular alopeciaSperling L, Cowper S, Knopp E. Temporal triangular alopecia 2012, 75-78. DOI: 10.3109/9780203490662.014.
  • Alopecia areataSperling L, Cowper S, Knopp E. Alopecia areata 2012, 79-95. DOI: 10.3109/9780203490662.015.
  • Psoriatic alopeciaSperling L, Cowper S, Knopp E. Psoriatic alopecia 2012, 96-101. DOI: 10.3109/9780203490662.016.
  • Tumor necrosis factor-alpha inhibitor associated psoriasiform alopecia (drug-induced psoriasiform alopecia)Sperling L, Cowper S, Knopp E. Tumor necrosis factor-alpha inhibitor associated psoriasiform alopecia (drug-induced psoriasiform alopecia) 2012, 102-107. DOI: 10.3109/9780203490662.017.
  • Syphilitic alopeciaSperling L, Cowper S, Knopp E. Syphilitic alopecia 2012, 108-110. DOI: 10.3109/9780203490662.018.
  • Dissecting cellulitis of the scalp (perifolliculitis capitis abscedens et suffodiens)Sperling L, Cowper S, Knopp E. Dissecting cellulitis of the scalp (perifolliculitis capitis abscedens et suffodiens) 2012, 166-170. DOI: 10.3109/9780203490662.029.
  • Erosive pustular dermatosisSperling L, Cowper S, Knopp E. Erosive pustular dermatosis 2012, 171-173. DOI: 10.3109/9780203490662.030.
  • Brocq’s alopecia (pseudopelade of Brocq) and end-stage cicatricial alopeciaSperling L, Cowper S, Knopp E. Brocq’s alopecia (pseudopelade of Brocq) and end-stage cicatricial alopecia 2012, 174-177. DOI: 10.3109/9780203490662.031.
  • Aplasia cutis congenita of the scalpSperling L, Cowper S, Knopp E. Aplasia cutis congenita of the scalp 2012, 178-180. DOI: 10.3109/9780203490662.032.
  • Tinea capitisSperling L, Cowper S, Knopp E. Tinea capitis 2012, 181-189. DOI: 10.3109/9780203490662.033.
  • Trichodysplasia of immunosuppressionSperling L, Cowper S, Knopp E. Trichodysplasia of immunosuppression 2012, 190-193. DOI: 10.3109/9780203490662.034.
  • Chemotherapy-induced alopeciaSperling L, Cowper S, Knopp E. Chemotherapy-induced alopecia 2012, 194-197. DOI: 10.3109/9780203490662.035.
  • An Atlas of Hair Pathology with Clinical Correlations, 2d Ed. (Book): Sperling L, Cowper SE, Knopp EA. Informs Healthcare, 2012An Atlas of Hair Pathology with Clinical Correlations, 2d Ed. (Book): Sperling L, Cowper SE, Knopp EA. Informs Healthcare, 2012