About

Juliana K Choi, MD., Ph.D., is an Associate Professor of Clinical Dermatology at the University of Pennsylvania's Perelman School of Medicine. She is part of the medical staff at Penn Presbyterian Medical Center, the Hospital of the University of Pennsylvania, the Philadelphia Veterans Affair Medical Center, and Pennsylvania Hospital. Her educational background includes a B.S. in Biology from the University of Illinois at Chicago, obtained in 2002, and both a Ph.D. in Anatomy & Cell Biology and an M.D., completed in 2010 at the same institution. Her professional work involves clinical dermatology, with a focus on research related to dermatologic drug therapy, cancer and Pseudomonas aeruginosa interactions, and dermatological conditions such as Darier Disease. She has contributed to the understanding of long-term acne treatments, the safety and effectiveness of medications like spironolactone and amoxicillin, and the impact of COVID-19 on dermatology residency programs. Dr. Choi's research and clinical interests are reflected in her numerous publications and her active role in the academic and medical community.

Research topics

• Medicine
• Pathology
• Internal medicine
• Computer Science
• Biology
• Surgery
• Oncology
• Computational biology
• Immunology
• Cancer research

Selected publications

• Chronic Sinusitis With Orbitonasal Bony Defect

  JAMA Otolaryngology–Head & Neck Surgery · 2026-04-30

  article

  A 75-year-old male with a history of chronic rhinosinusitis and prior sinus surgery presented with symptoms of persistent nasal congestion, drainage, and ocular irritation with blurred vision and discharge. What is your diagnosis?

  PublisherDOI

• When Central Tolerance Fails: Thymic Malignancies at the Intersection of Cancer Immunity and Autoimmunity

  Cancers · 2026-02-26 · 2 citations

  articleOpen access

  Thymic malignancies are rare cancers arising from thymic epithelial cells and are characterized by a highly diverse clinical phenotype, substantial histologic and morphologic heterogeneity, and frequent associations with autoimmune syndromes. Although the clinical, immunological, and cytoarchitectural changes associated with thymomas have been increasingly elucidated in the contemporary literature, very few studies have interrogated the direct role of tumor staging and histological grading in shaping autoimmunity burden and infection risk. In this narrative review, we synthesize contemporary clinical, immunological, and morphologic evidence linking thymic architecture and selection defects to the spectrum of paraneoplastic autoimmunity (MG, pure red cell aplasia, Good's syndrome) and to infectious vulnerability. We further appraise emerging therapeutic strategies, including immune checkpoint inhibition and adoptive cellular approaches, through a patient-stratified lens, emphasizing efficacy signals, immune-related adverse events, and practical considerations for selection and monitoring. We conclude by highlighting priorities for future investigation, including refining autoantibody signatures; mapping thymic microenvironments that drive tolerance failure, and prospectively evaluating stratified immunotherapeutic regimens that balance benefit with immune-mediated risk.

  PublisherOA PDFDOI

• p63-Positive Diffuse Large B-cell Lymphoma of Oropharynx: A Treacherous Mimic of HPV-Related Squamous Cell Carcinoma—A Report of Three Cases

  Head and Neck Pathology · 2026-01-23

  articleOpen access
  PublisherOA PDFDOI

• ROBOTIC-ASSISTED ENDOSCOPIC SURGERY IN LUMBAR SPINE: A TECHNICAL OVERVIEW AND CASE DEMONSTRATION

  Journal of Musculoskeletal Research · 2025-06-01

  articleSenior author

  Endoscopic spine surgery is expected to advance as endoscopic instruments become fully developed and navigable by robotic-assisted systems. This combination promises to revolutionize spine surgery, making procedures less invasive and more precise. Adopting these technologies can improve patient outcomes. A 70-year-old man was referred to our clinic presenting with right leg pain, clamping, and numbness along the right lateral aspect of the lower leg. Upon physical examination, manual muscle power testing confirmed a grade 5 strength, decreased pinprick, and light touch sensation along the L4 dermatome area of the right leg. The initial diagnosis was right L4/5 neural foramen stenosis. The procedure utilized the Excelsius GPS robotic guidance system for a robotic-assisted right L45 lateral recess and foraminal decompression via a left contralateral approach. His symptoms, particularly the right leg pain and cramping, showed significant improvement. The ongoing development and integration of robotic systems in spine surgery present substantial benefits, including increased accuracy of surgical incisions and instrument placement, reduced operative time, and decreased radiation exposure. The new electromagnetic tracking navigation system used with robotic systems may offer a better solution than the optical navigation system for reducing pin site pain and radiation exposure. However, challenges such as the suitability of robotic instruments for endoscopic spine surgery and the associated learning curve must be addressed.

  PublisherDOI

• Minimally Invasive Robotic Approach to Treating Cement Leakage Into the Psoas: A Case Report

  Cureus · 2025-12-01

  articleOpen access

  A 78-year-old woman developed groin and thigh pain, numbness, and hip flexion weakness. Imaging revealed cement leakage from an L4 screw into the psoas, compressing a lumbar plexus branch. Using a spinal robotic system (ExcelsiusGPS, Globus Medical, Inc., Audubon, PA), a minimally invasive approach enabled precise incision planning, safe psoas dissection, and en bloc cement removal. Symptoms resolved immediately. Symptomatic intrapsoas cement leakage causing radiculopathy is rare, and robotic guidance contributed to a safe, accurate procedure.

  PublisherOA PDFDOI

• A T-cell intrinsic Role for <i>APOL1</i> Risk Alleles in Allograft Rejection

  bioRxiv (Cold Spring Harbor Laboratory) · 2025-07-18

  preprintOpen access

  Abstract African Americans have an increased risk of kidney disease due to exonic variants in Apolipoprotein-L1 (G1 and G2). These prevalent variants have also been linked with kidney rejection, but outside of association with African ancestry, underpinning causal mechanisms are unknown. We investigated T-cell function using transgenic mice with physiologic expression of wild type (G0-), G1-, or G2-APOL1. Mice with variant APOL1 showed greater CD8+T-cell activation with expansion of a central memory (TCM) subset. Stimulated G1-CD8+T-cells showed enhanced proliferation and cytokine production, which reversed with APOL1 inhibition. In MHC-mismatched cardiac transplants, G1-mice demonstrated greater CD8+T-cell infiltration and reduced survival. Bulk transcriptome of G1-CD8+T-cells, and single-cell transcriptome of graft infiltrating TCMs, showed enrichment of canonical T-cell receptor (TCR) pathways including Ca 2+ -signaling. G1-CD8+T-cells demonstrated baseline ER-Ca 2+ depletion followed by sustained increases in cytosolic-Ca 2+ upon TCR stimulation. G1-CD8+T-cells were more sensitive to Ca 2+ chelation, or store-operated Ca 2+ entry inhibition, and relatively resistant to calcineurin antagonism vs. G0-CD8+T-cells. Analogously, in a kidney transplant cohort, APOL1-variant recipients developed rejection when they had elevated peripheral TCMs before transplantation and despite significantly higher tacrolimus levels vs G0/G0-AAs with rejection. In summary, we unravel an excitatory T-cell intrinsic mechanism for APOL1 exonic variants, causally linking them with kidney rejection.

  PublisherOA PDFDOI

• Enhancing diagnostics through flow cytometry: overcoming barriers in low resource settings

  Frontiers in Oncology · 2025-09-12 · 1 citations

  articleOpen access

  Despite advancements in the treatment of acute lymphoblastic leukemia (ALL), survival rates vary greatly based on factors such as cancer subtype and geographical location. The use of diagnostic tools like immunophenotyping and measurable residual disease (MRD) detection by flow cytometry (FC) are key to optimal management. FC offers higher sensitivity and rapid turnaround compared to traditional methods like morphological evaluation and immunohistochemistry. However, in low- and middle-income countries (LMIC), the adoption of robust MRD assays via FC remains limited due to challenges such as technical complexity, the need for operator expertise, and the high costs associated with antibodies and quality control. This study discusses the design, implementation, and validation of MRD strategies using FC in resource-constrained environments, highlighting the potential for improved accessibility and patient outcomes when these barriers are addressed.

  PublisherOA PDFDOI

• 0654 Characterizing racial demographics in mycosis fungoides/sezary syndrome clinical trials

  Journal of Investigative Dermatology · 2025-07-21

  article
  PublisherDOI

• Acute Undifferentiated Leukemia and Mixed-Phenotype Acute Leukemias

  Elsevier eBooks · 2025-07-25

  book-chapter1st authorCorresponding
  PublisherDOI

• Post-transplant maintenance with sorafenib is safe and effective in pediatric patients with har FLT3/ITD AML: A report from the Children's oncology group protocol AAML1031

  Blood · 2025-11-03

  article

  Abstract Introduction Patients with acute myeloid leukemia (AML) with an internal tandem duplication mutation of FLT3 (FLT3/ITD) have a high risk of relapse and cure with chemotherapy alone is rare. FLT3 tyrosine kinase inhibitors (TKIs) target the oncogenic FLT3 receptor to improve outcomes in this poor prognosis subset. COG AAML1031 studied the feasibility and efficacy of adding sorafenib to multi-agent chemotherapy in pediatric patients with FLT3/ITD AML and demonstrated improved disease-free survival compared to a similar a cohort of similar FLT3/ITD+ patients who did not receive TKI. The objective of this analysis was to examine the tolerability and efficacy of sorafenib, specifically when added as maintenance after hematopoietic cell transplantation (HCT). Methods On COG AAML1031, pediatric patients with FLT3/ITD AML (high allelic ratio (HAR) &amp;gt;0.4) were eligible to receive sorafenib plus conventional chemotherapy with each treatment course followed by allogeneic HCT. After HCT, patients could reinitiate sorafenib (starting at 100 mg/m2 with predefined escalation/de-escalation) between day +40-100 and receive for one year from restart. Criteria to restart included adequate hematopoietic recovery without evidence of relapse, no acute GVHD and adequate cardiovascular function (shortening fraction &amp;gt; 28%, no severe hypertension). Patients who received at least one dose of sorafenib after HCT were considered exposed. A control cohort was compiled of (1) patients from AAML0531 arm B who received identical chemotherapy, without sorafenib (n=13), (2) patients on AAML1031 with HAR FLT3/ITD who did not receive any sorafenib (n=6), and (3) patients on AAML1031 who only received pre-HCT sorafenib but did not restart after (n=25). All control patients had received allogeneic HCT on study in first remission. Cumulative incidence of relapse (CIR) after HCT was the primary outcome measure. Post-HCT sorafenib was treated as a time-dependent exposure and non-relapse mortality was a competing event. Results The analysis included 74 patients, 30 with post-HCT sorafenib exposure (post-HCT TKI) and 44 control patients (no post-HCT TKI); of the controls, 25 received pre-HCT sorafenib (pre-HCT TKI only) and 19 never received sorafenib (no TKI). Post-HCT TKI patients were more likely to be non-Hispanic white (83% versus 62%, p=0.012), but otherwise demographic, disease and transplant characteristics, as well as follow up time from HCT, were similar between the post-HCT TKI and control groups. Compared to subjects with pre-HCT TKI only, those who received post-HCT TKI were more likely to have received 3 full courses (87% versus 72%, p = 0.09). Median start day of TKI was 74 (range 42-110); one patient relapsed before day 40. The 5-year CIR for those with post-HCT TKI was 21% (95%CI 8-38%) and for controls was 34% (95%CI 21-48%); HR 0.70, p = 0.416. Median time to relapse was longer in patients who received maintenance (4 versus 15 months). 5-year overall survival (OS) also favored receipt of sorafenib, 90% (95%CI 71%-97%) versus 57% (95%CI 41-70%), OS log-rank p value 0.008. In a sensitivity analysis comparing the post-HCT TKI cohort to the cohort that received pre-HCT TKI only, CIR results were similar (HR = 0.67, p = 0.42) as were OS results (log rank p value .001, 5y OS 90% versus 44%). Sorafenib was well tolerated after HCT; 20/30 (66%) patients were able to complete the full year of treatment, although dose reductions compared to initial dose were common (30%, 24%, 15% in cycles 1-3, respectively). Only 1/3 of subjects experienced an AE of any grade in each cycle, none greater that grade 3, except for one grade 4 neutropenia in cycle 2. The most common grade 3 AE was ALT elevation (13%, cycle 1). The cumulative incidence of acute or chronic graft versus host disease (GVHD) was similar among patients who did and did not receive sorafenib, HR = 0.83 (95%CI 0.38-1.78, p=0.63). Conclusions This prospective study of post-HCT sorafenib maintenance therapy in de novo HAR FLT3/ITD+ pediatric AML demonstrated a clinically, but not statistically significant, reduction in relapse risk and an acceptable side effect profile. Patients who received sorafenib also have substantially improved OS but this may be in part due to a favorable clinical status among patients who restart sorafenib. Further work is needed to understand whether its benefit is limited to specific disease subsets and/or those with pre HCT MRD and to clarify the optimal duration of dosing.

  PublisherDOI

Recent grants

• NIH Grant K08CA075330

  NIH · $445k · 2003

Frequent coauthors

• Ching‐Hon Pui

  St. Jude Children's Research Hospital

  60 shared

• Hiroto Inaba

  St. Jude Children's Research Hospital

  58 shared

• Sima Jeha

  St. Jude Children's Research Hospital

  49 shared

• David T. Teachey

  Children's Hospital of Philadelphia

  47 shared

• Raul C. Ribeiro

  St. Jude Children's Research Hospital

  45 shared

• Charles G. Mullighan

  St. Jude Children's Research Hospital

  44 shared

• Jeffrey E. Rubnitz

  41 shared

• Susana C. Raimondi

  St. Jude Children's Research Hospital

  40 shared