Recent items - Journal of the American Academy of Dermatology
Recruiting subjects for research studies in the era of Web 2.0
13/08/2010 17:47
To the Editor: Subject recruitment is a frequent obstacle when conducting human subject research. While the print media industry is facing a precipitous decline, online media now offer sophisticated tools to deliver timely, targeted messages to consumers. These online tools offer new ways for researchers to reach potential subjects.
13/08/2010 17:47
To the Editor: Subject recruitment is a frequent obstacle when conducting human subject research. While the print media industry is facing a precipitous decline, online media now offer sophisticated tools to deliver timely, targeted messages to consumers. These online tools offer new ways for researchers to reach potential subjects.
Differential usefulness of biomarkers thymus and activation-regulated chemokine and soluble CD30 during enteric coated mycophenolate sodium and cyclosporine therapy in atopic dermatitis
13/08/2010 17:47
To the Editor: Evaluating disease activity in patients with atopic dermatitis (AD) using the SCORing Atopic Dermatitis (SCORAD) index is hindered by subjectivities and intraobserver variations in time. Therefore, an objective biomarker corresponding to disease severity is urgently needed. However, the usefulness of a biomarker should not be dependent on the choice of therapy. This pilot study evaluated the applicability of potential biomarkers including soluble CD30 (sCD30) and thymus and activa [...]
13/08/2010 17:47
To the Editor: Evaluating disease activity in patients with atopic dermatitis (AD) using the SCORing Atopic Dermatitis (SCORAD) index is hindered by subjectivities and intraobserver variations in time. Therefore, an objective biomarker corresponding to disease severity is urgently needed. However, the usefulness of a biomarker should not be dependent on the choice of therapy. This pilot study evaluated the applicability of potential biomarkers including soluble CD30 (sCD30) and thymus and activa [...]
Rapid resolution of pyoderma gangrenosum after treatment with intravenous cyclosporine
13/08/2010 17:47
To the Editor: A 48-year-old white female presented to our clinic with a 1-week history of leg pain and worsening abdominal pain. Her medical history was significant for ulcerative colitis (UC) treated with azathioprine, mesalamine, and sulfasalazine. The physical examination revealed multiple tender, violaceous raised papules and nodules on the legs bilaterally. On the left shin was a large annular plaque with central maceration and purple hemorrhagic papules and pustules with suppuration at th [...]
13/08/2010 17:47
To the Editor: A 48-year-old white female presented to our clinic with a 1-week history of leg pain and worsening abdominal pain. Her medical history was significant for ulcerative colitis (UC) treated with azathioprine, mesalamine, and sulfasalazine. The physical examination revealed multiple tender, violaceous raised papules and nodules on the legs bilaterally. On the left shin was a large annular plaque with central maceration and purple hemorrhagic papules and pustules with suppuration at th [...]
Basal cell carcinoma and atypical fibroxanthoma: An unusual collision tumor
13/08/2010 17:47
To the Editor: We report the case of an 85-year-old white female who presented to our dermatology department with a 2.5 cm × 1.8 cm asymptomatic erythematous plaque of 3 years' duration on the nose. The plaque had a translucent border and fine telangiectasias and was centred by a black/violaceous hemorrhagic nodule (, A).
13/08/2010 17:47
To the Editor: We report the case of an 85-year-old white female who presented to our dermatology department with a 2.5 cm × 1.8 cm asymptomatic erythematous plaque of 3 years' duration on the nose. The plaque had a translucent border and fine telangiectasias and was centred by a black/violaceous hemorrhagic nodule (, A).
Cicatricial alopecia
13/08/2010 17:47
A 56-year-old woman with a medical history significant for idiopathic thrombocytopenic purpura presented with patchy areas of hair loss that have been progressing over the last 2 years. A previous treatment with nizoral shampoo did not lead to significant improvement. The physical examination revealed discrete patches of scarring alopecia with central hypopigmentation and erythema ().
13/08/2010 17:47
A 56-year-old woman with a medical history significant for idiopathic thrombocytopenic purpura presented with patchy areas of hair loss that have been progressing over the last 2 years. A previous treatment with nizoral shampoo did not lead to significant improvement. The physical examination revealed discrete patches of scarring alopecia with central hypopigmentation and erythema ().
Pink plaque on a teenager's face
13/08/2010 17:47
An 18-year-old otherwise healthy female presented with a 1-month history of an enlarging and mildly pruritic lesion on her face. She had noted the presence of clear material oozing out when she squeezed the area. The physical examination revealed a 15-mm pink plaque on her left upper cutaneous lip, with slight accentuation around the hair follicles (, A). The rest of her cutaneous examination was normal. An incisional biopsy specimen revealed follicular structures filled with mucin (, B), hig [...]
13/08/2010 17:47
An 18-year-old otherwise healthy female presented with a 1-month history of an enlarging and mildly pruritic lesion on her face. She had noted the presence of clear material oozing out when she squeezed the area. The physical examination revealed a 15-mm pink plaque on her left upper cutaneous lip, with slight accentuation around the hair follicles (, A). The rest of her cutaneous examination was normal. An incisional biopsy specimen revealed follicular structures filled with mucin (, B), hig [...]
Linear acral lesions in an infant
13/08/2010 17:47
A 6-month-old girl had asymptomatic unilateral hyperkeratotic verrucous plaques with keratotic spicules following the lines of Blaschko on the left hand, forearm, and foot, all of which had been present since birth ( and ). Linear erythematous papules were present from the left abdomen to the upper aspect of the back. The patient was otherwise healthy. Histologically, parakeratotic columns originated from hyperplastic eccrine ducts ().
13/08/2010 17:47
A 6-month-old girl had asymptomatic unilateral hyperkeratotic verrucous plaques with keratotic spicules following the lines of Blaschko on the left hand, forearm, and foot, all of which had been present since birth ( and ). Linear erythematous papules were present from the left abdomen to the upper aspect of the back. The patient was otherwise healthy. Histologically, parakeratotic columns originated from hyperplastic eccrine ducts ().
Factors associated with large cutaneous squamous cell carcinomas
13/08/2010 17:47
Background: Large cutaneous squamous cell carcinoma (SCC) is associated with a higher risk of disfigurement, local recurrence, and metastasis; however, little is known about factors associated with tumor size at diagnosis.Objectives: We sought to evaluate factors associated with SCC size, including diagnostic/treatment delay and patient and tumor characteristics.Methods: We studied a stratified sample of 308 patients with SCC recently treated at a dermatologic referral center in Italy. Medical r [...]
13/08/2010 17:47
Background: Large cutaneous squamous cell carcinoma (SCC) is associated with a higher risk of disfigurement, local recurrence, and metastasis; however, little is known about factors associated with tumor size at diagnosis.Objectives: We sought to evaluate factors associated with SCC size, including diagnostic/treatment delay and patient and tumor characteristics.Methods: We studied a stratified sample of 308 patients with SCC recently treated at a dermatologic referral center in Italy. Medical r [...]
Lack of evidence for basal or squamous cell carcinoma infection with Merkel cell polyomavirus in immunocompetent patients with Merkel cell carcinoma
13/08/2010 17:47
Background: Merkel cell polyomavirus (MCV) was discovered by digital transcriptome subtraction as a monoclonal infection of Merkel cell carcinoma (MCC) tumors. Subsequent studies have repeatedly confirmed that MCV is the likely cause for most MCC. Polymerase chain reaction–based detection of the virus in other nonmelanoma skin cancers, however, has been inconsistent and controversial.Objective: We sought to directly assay for MCV infection in squamous cell carcinoma (SCC) or basal cell carcinoma [...]
13/08/2010 17:47
Background: Merkel cell polyomavirus (MCV) was discovered by digital transcriptome subtraction as a monoclonal infection of Merkel cell carcinoma (MCC) tumors. Subsequent studies have repeatedly confirmed that MCV is the likely cause for most MCC. Polymerase chain reaction–based detection of the virus in other nonmelanoma skin cancers, however, has been inconsistent and controversial.Objective: We sought to directly assay for MCV infection in squamous cell carcinoma (SCC) or basal cell carcinoma [...]
Dermatoscopy use by US dermatologists: A cross-sectional survey
13/08/2010 17:47
Background: Although dermatoscopy is widely used in Europe and Australia, little is known about dermatoscopy use by US dermatologists.Objective: We sought to estimate the prevalence of dermatoscopy use by US dermatologists and examine associations with practice characteristics.Methods: We conducted a cross-sectional survey of all US fellows of the American Academy of Dermatology.Results: Of 8501 eligible recipients, 3238 (38.1%) surveys were completed and returned. Of respondents, 48% used derma [...]
13/08/2010 17:47
Background: Although dermatoscopy is widely used in Europe and Australia, little is known about dermatoscopy use by US dermatologists.Objective: We sought to estimate the prevalence of dermatoscopy use by US dermatologists and examine associations with practice characteristics.Methods: We conducted a cross-sectional survey of all US fellows of the American Academy of Dermatology.Results: Of 8501 eligible recipients, 3238 (38.1%) surveys were completed and returned. Of respondents, 48% used derma [...]
Androgenetic alopecia and cardiovascular risk factors in men and women: A comparative study
13/08/2010 17:47
Background: Numerous studies in recent decades have associated male androgenetic alopecia (AGA) with the risk of cardiovascular disease. However, only 3 studies have addressed this association in female patients. Most studies considered the risk of myocardial infarction or mortality as a result of heart disease, without analyzing cardiovascular risk factors.Objectives: The objectives of this study were to analyze the presence of cardiovascular risk factors included in the Adult Treatment Panel-I [...]
13/08/2010 17:47
Background: Numerous studies in recent decades have associated male androgenetic alopecia (AGA) with the risk of cardiovascular disease. However, only 3 studies have addressed this association in female patients. Most studies considered the risk of myocardial infarction or mortality as a result of heart disease, without analyzing cardiovascular risk factors.Objectives: The objectives of this study were to analyze the presence of cardiovascular risk factors included in the Adult Treatment Panel-I [...]
Effect of hair color and sun sensitivity on nevus counts in white children in Colorado
13/08/2010 17:47
Background: It has been widely reported that individuals with a light phenotype (ie, light hair color, light base skin color, and propensity to burn) have more nevi and are at greater risk for developing skin cancer. No studies have systematically investigated how phenotypic traits may interact in relation to nevus development.Objective: We sought to systematically examine whether any combinations of phenotype are associated with a greater or lesser risk for nevus development in white children.M [...]
13/08/2010 17:47
Background: It has been widely reported that individuals with a light phenotype (ie, light hair color, light base skin color, and propensity to burn) have more nevi and are at greater risk for developing skin cancer. No studies have systematically investigated how phenotypic traits may interact in relation to nevus development.Objective: We sought to systematically examine whether any combinations of phenotype are associated with a greater or lesser risk for nevus development in white children.M [...]
Phenotypic variability among café-au-lait macules in neurofibromatosis type 1
13/08/2010 17:47
Background: Café-au-lait macules (CALMs) in neurofibromatosis type 1 (NF1) are an early and accessible phenotype in NF1, but have not been extensively studied.Objective: We sought to more fully characterize the phenotype of CALMs in patients with NF1.Methods: In all, 24 patients with a diagnosis of NF1 confirmed through clinical diagnosis or molecular genetic testing were recruited from patients seen in the genetics department at the University of Alabama at Birmingham. CALM locations were mappe [...]
13/08/2010 17:47
Background: Café-au-lait macules (CALMs) in neurofibromatosis type 1 (NF1) are an early and accessible phenotype in NF1, but have not been extensively studied.Objective: We sought to more fully characterize the phenotype of CALMs in patients with NF1.Methods: In all, 24 patients with a diagnosis of NF1 confirmed through clinical diagnosis or molecular genetic testing were recruited from patients seen in the genetics department at the University of Alabama at Birmingham. CALM locations were mappe [...]
Efficacy and safety of adalimumab across subgroups of patients with moderate to severe psoriasis
13/08/2010 17:47
Background: The phase III randomized controlled evaluation of adalimumab every other week dosing in moderate to severe psoriasis trial (REVEAL) demonstrated adalimumab induced significant improvements and was well tolerated for patients with moderate to severe psoriasis.Objective: We sought to determine the efficacy and safety of adalimumab for various subgroups of patients in REVEAL with moderate to severe psoriasis and to determine whether these profiles were consistent with the overall result [...]
13/08/2010 17:47
Background: The phase III randomized controlled evaluation of adalimumab every other week dosing in moderate to severe psoriasis trial (REVEAL) demonstrated adalimumab induced significant improvements and was well tolerated for patients with moderate to severe psoriasis.Objective: We sought to determine the efficacy and safety of adalimumab for various subgroups of patients in REVEAL with moderate to severe psoriasis and to determine whether these profiles were consistent with the overall result [...]
Ustekinumab significantly improves symptoms of anxiety, depression, and skin-related quality of life in patients with moderate-to-severe psoriasis: Results from a randomized, double-blind, placebo-controlled phase III trial
13/08/2010 17:47
Background: Anxiety, depression, and impaired health-related quality of life (HRQoL) are common in patients with psoriasis.Objective: We sought to analyze the effect of ustekinumab on these conditions in patients with moderate-to-severe psoriasis.Methods: Patients with moderate-to-severe psoriasis (n = 1230) were randomized 1:1:1 to receive 45 mg of ustekinumab, 90 mg of ustekinumab, or placebo. The Hospital Anxiety and Depression Scale was used to measure anxiety and depression, and the Dermato [...]
13/08/2010 17:47
Background: Anxiety, depression, and impaired health-related quality of life (HRQoL) are common in patients with psoriasis.Objective: We sought to analyze the effect of ustekinumab on these conditions in patients with moderate-to-severe psoriasis.Methods: Patients with moderate-to-severe psoriasis (n = 1230) were randomized 1:1:1 to receive 45 mg of ustekinumab, 90 mg of ustekinumab, or placebo. The Hospital Anxiety and Depression Scale was used to measure anxiety and depression, and the Dermato [...]
Bilateral forearm intravenous regional anesthesia with prilocaine for botulinum toxin treatment of palmar hyperhidrosis
13/08/2010 17:47
Background: Treatment of palmar hyperhidrosis with botulinum toxin (BTX) requires effective anesthesia, but previous methods have not provided enough pain relief or have resulted in a prolonged impaired hand function.Objective: This is a study of bilateral forearm intravenous regional anesthesia using prilocaine for BTX treatment of palmar hyperhidrosis.Methods: In all, 166 patients (100 female and 66 male) were treated bilaterally with intracutaneous BTX type A injections using intravenous regi [...]
13/08/2010 17:47
Background: Treatment of palmar hyperhidrosis with botulinum toxin (BTX) requires effective anesthesia, but previous methods have not provided enough pain relief or have resulted in a prolonged impaired hand function.Objective: This is a study of bilateral forearm intravenous regional anesthesia using prilocaine for BTX treatment of palmar hyperhidrosis.Methods: In all, 166 patients (100 female and 66 male) were treated bilaterally with intracutaneous BTX type A injections using intravenous regi [...]
Deroofing: A tissue-saving surgical technique for the treatment of mild to moderate hidradenitis suppurativa lesions
13/08/2010 17:47
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease, often refractory to treatment. Patients with HS and dermatologists are in need of an effective, fast surgical intervention technique. Deroofing is a tissue-saving technique, whereby the “roof” of an abscess, cyst, or sinus tract is electrosurgically removed. The use of a probe is mandatory to explore the full extent of a lesion.Objective: We sought to evaluate the efficacy and patient satisfaction of the deroofing [...]
13/08/2010 17:47
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease, often refractory to treatment. Patients with HS and dermatologists are in need of an effective, fast surgical intervention technique. Deroofing is a tissue-saving technique, whereby the “roof” of an abscess, cyst, or sinus tract is electrosurgically removed. The use of a probe is mandatory to explore the full extent of a lesion.Objective: We sought to evaluate the efficacy and patient satisfaction of the deroofing [...]
Commentary: Unroofing for hidradenitis suppurativa, why and how
13/08/2010 17:47
See related article on page 475 Traditional surgery for hidradenitis suppurativa (HS) consists of en bloc wide excision followed by primary closure or healing by secondary intent. A simpler technique consists of careful unroofing, exploration, and debridement of the scars, abscesses, cysts, and complex sinuses that characterize HS. Elsewhere in the Journal, van der Zee et al show us how. The following comments are directed at why this technique (which van der Zee et al refer to as “deroofing”) [...]
13/08/2010 17:47
See related article on page 475 Traditional surgery for hidradenitis suppurativa (HS) consists of en bloc wide excision followed by primary closure or healing by secondary intent. A simpler technique consists of careful unroofing, exploration, and debridement of the scars, abscesses, cysts, and complex sinuses that characterize HS. Elsewhere in the Journal, van der Zee et al show us how. The following comments are directed at why this technique (which van der Zee et al refer to as “deroofing”) [...]
The imbalanced expression of matrix metalloproteinases in nephrogenic systemic fibrosis
13/08/2010 17:47
Background: Nephrogenic systemic fibrosis (NSF) occurs in patients with renal dysfunction and gadolinium exposure. Although little is known about the pathogenesis of this disease, increased expression of transforming growth factor-β has been recently demonstrated. Other fibrosing conditions have been shown to express an imbalance in matrix metalloproteinase (MMP) expression and their corresponding inhibitors. Myofibroblast differentiation, in which cells often express α-smooth muscle actin and a [...]
13/08/2010 17:47
Background: Nephrogenic systemic fibrosis (NSF) occurs in patients with renal dysfunction and gadolinium exposure. Although little is known about the pathogenesis of this disease, increased expression of transforming growth factor-β has been recently demonstrated. Other fibrosing conditions have been shown to express an imbalance in matrix metalloproteinase (MMP) expression and their corresponding inhibitors. Myofibroblast differentiation, in which cells often express α-smooth muscle actin and a [...]
Expression of proliferative biomarkers in anal intraepithelial neoplasia of HIV-positive men
13/08/2010 17:47
Background: Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV)–associated precursor lesion of anal carcinoma, is highly prevalent among HIV-infected individuals, especially in men having sex with men (MSM). Early diagnosis and treatment of AIN might prevent development of anal cancer.Objectives: We aimed to evaluate the expression of 8 promising proliferative biomarkers in anal dysplasia and to compare the efficacy of these markers in diagnosing high-grade AIN.Methods: Immunohist [...]
13/08/2010 17:47
Background: Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV)–associated precursor lesion of anal carcinoma, is highly prevalent among HIV-infected individuals, especially in men having sex with men (MSM). Early diagnosis and treatment of AIN might prevent development of anal cancer.Objectives: We aimed to evaluate the expression of 8 promising proliferative biomarkers in anal dysplasia and to compare the efficacy of these markers in diagnosing high-grade AIN.Methods: Immunohist [...]
Spreading pigmented actinic keratosis: A review
13/08/2010 17:47
Introduction: Spreading pigmented actinic keratosis (SPAK) is a common, but uncommonly reported or appreciated, variant of classic actinic keratosis (AK). It can mimic different pigmented lesions, which may be benign (eg, solar lentigo) or malignant (eg, lentigo maligna).Objective: We sought to review current data and identify areas needing further research to establish diagnostic guidelines for SPAK and to increase awareness of this common entity.Methods: A literature search was performed in bo [...]
13/08/2010 17:47
Introduction: Spreading pigmented actinic keratosis (SPAK) is a common, but uncommonly reported or appreciated, variant of classic actinic keratosis (AK). It can mimic different pigmented lesions, which may be benign (eg, solar lentigo) or malignant (eg, lentigo maligna).Objective: We sought to review current data and identify areas needing further research to establish diagnostic guidelines for SPAK and to increase awareness of this common entity.Methods: A literature search was performed in bo [...]
Cocaine-associated retiform purpura and neutropenia: Is levamisole the culprit?
13/08/2010 17:47
To the Editor: We describe two patients with neutropenia and retiform purpura associated with cocaine use and alert clinicians to the possible emerging public health threat of levamisole-contaminated cocaine.
13/08/2010 17:47
To the Editor: We describe two patients with neutropenia and retiform purpura associated with cocaine use and alert clinicians to the possible emerging public health threat of levamisole-contaminated cocaine.
Acute generalized exanthematous pustulosis associated with icodextrin
13/08/2010 17:47
To the Editor: A 55-year-old African American man with chronic renal failure receiving peritoneal dialysis presented to the emergency department with a 3-day history of a generalized, progressive, erythematous, slightly pruritic eruption of abrupt onset. He complained of subjective fevers and chills in addition to malaise, nausea, vomiting, and diarrhea. He was admitted to the intensive care unit with hypotension.
13/08/2010 17:47
To the Editor: A 55-year-old African American man with chronic renal failure receiving peritoneal dialysis presented to the emergency department with a 3-day history of a generalized, progressive, erythematous, slightly pruritic eruption of abrupt onset. He complained of subjective fevers and chills in addition to malaise, nausea, vomiting, and diarrhea. He was admitted to the intensive care unit with hypotension.
A nonsteroidal alternative to impetiginized eczema in the emergency room
13/08/2010 17:47
To the Editor: In the April 2008 issue of the Journal, we reported the use of gentian violet to treat oral hairy leukoplakia in an HIV-infected individual, and we would like to add an additional description of the use of gentian violet for the treatment of superinfected atopic dermatitis. A 38-year-old white man with a history of mild atopic dermatitis on his extremities presented to the emergency room with a 3-day history of painful, erythematous, oozing plaques in the bilateral axillae and ing [...]
13/08/2010 17:47
To the Editor: In the April 2008 issue of the Journal, we reported the use of gentian violet to treat oral hairy leukoplakia in an HIV-infected individual, and we would like to add an additional description of the use of gentian violet for the treatment of superinfected atopic dermatitis. A 38-year-old white man with a history of mild atopic dermatitis on his extremities presented to the emergency room with a 3-day history of painful, erythematous, oozing plaques in the bilateral axillae and ing [...]
Vitamins and photoaging: Do scientific data support their use?
13/08/2010 17:47
With the rise of the cosmeceutical industry, numerous formulations have surfaced with claims of reducing the clinical manifestations of photoaging. Many of these products capitalize on the positive connection the public makes with vitamins, especially with respect to their antioxidant capabilities. An impressive amount of basic science and clinical research has been conducted in both an attempt to discover novel strategies for preventing detrimental sun damage and to validate the addition of vit [...]
13/08/2010 17:47
With the rise of the cosmeceutical industry, numerous formulations have surfaced with claims of reducing the clinical manifestations of photoaging. Many of these products capitalize on the positive connection the public makes with vitamins, especially with respect to their antioxidant capabilities. An impressive amount of basic science and clinical research has been conducted in both an attempt to discover novel strategies for preventing detrimental sun damage and to validate the addition of vit [...]
Dermatitis herpetiformis: Pearls and pitfalls in diagnosis and management
13/08/2010 17:47
Dialogues in Dermatology, a monthly audio program from the American Academy of Dermatology, contains discussions between dermatologists on timely topics. Commentaries from Dialogues Editor-in-Chief Jacqueline M. Junkins-Hopkins, MD, are provided after each discussion as a topic summary and are provided here as a special service to readers of the Journal of the American Academy of Dermatology.
13/08/2010 17:47
Dialogues in Dermatology, a monthly audio program from the American Academy of Dermatology, contains discussions between dermatologists on timely topics. Commentaries from Dialogues Editor-in-Chief Jacqueline M. Junkins-Hopkins, MD, are provided after each discussion as a topic summary and are provided here as a special service to readers of the Journal of the American Academy of Dermatology.
Identification of a novel mutation in the DSRAD gene in a Chinese family with dyschromatosis symmetrica hereditaria
13/08/2010 17:47
To the Editor: Dyschromatosis symmetrica hereditaria (DSH) is a rare autosomal dominant skin disease that is characterized by a mixture of hyperpigmented and hypopigmented macules on the face and dorsal aspects of the extremities. Genetic studies have confirmed that a mutation of the double-stranded, RNA-specific adenosine deaminase (DSRAD, also called ADAR1) gene is responsible for this disorder. In this study, we screened the DSRAD gene for mutations in a Chinese family with DSH.
13/08/2010 17:47
To the Editor: Dyschromatosis symmetrica hereditaria (DSH) is a rare autosomal dominant skin disease that is characterized by a mixture of hyperpigmented and hypopigmented macules on the face and dorsal aspects of the extremities. Genetic studies have confirmed that a mutation of the double-stranded, RNA-specific adenosine deaminase (DSRAD, also called ADAR1) gene is responsible for this disorder. In this study, we screened the DSRAD gene for mutations in a Chinese family with DSH.
Aleukemic leukemia cutis with extensive bone involvement
13/08/2010 17:47
To the Editor: Aleukemic leukemia cutis (ALC) is a rare condition that is characterized by the invasion of leukemic cells into the skin before such cells are observed in the peripheral blood. We present a case of ALC with multiple bone metastases.
13/08/2010 17:47
To the Editor: Aleukemic leukemia cutis (ALC) is a rare condition that is characterized by the invasion of leukemic cells into the skin before such cells are observed in the peripheral blood. We present a case of ALC with multiple bone metastases.
Onychopapilloma presenting as longitudinal leukonychia
13/08/2010 17:47
To the Editor: Onychopapilloma is an uncommon benign nail neoplasm characterized histologically by distal subungal hyperkeratosis and nail matrix metaplasia of the nail bed with marked papillomatosis. The majority of cases present clinically as localized longitudinal erythronychia. We report a case of onychopapilloma presenting as localized longitudinal leukonychia.
13/08/2010 17:47
To the Editor: Onychopapilloma is an uncommon benign nail neoplasm characterized histologically by distal subungal hyperkeratosis and nail matrix metaplasia of the nail bed with marked papillomatosis. The majority of cases present clinically as localized longitudinal erythronychia. We report a case of onychopapilloma presenting as localized longitudinal leukonychia.
JAAD Grand Rounds quiz∗ Patch of “difficult to comb” hair
13/08/2010 17:47
Learning objectives: At the conclusion of this learning activity, physician participants should be able to assess their own diagnostic and patient management skills and use the results of this exercise to help determine personal learning needs that can be addressed through subsequent CME involvement. Instructions for claiming CME credit appear in the front advertising section. See last page of Contents for page number.Instructions: In answering each question, refer to the specific directions pro [...]
13/08/2010 17:47
Learning objectives: At the conclusion of this learning activity, physician participants should be able to assess their own diagnostic and patient management skills and use the results of this exercise to help determine personal learning needs that can be addressed through subsequent CME involvement. Instructions for claiming CME credit appear in the front advertising section. See last page of Contents for page number.Instructions: In answering each question, refer to the specific directions pro [...]
A woman with focal alopecia
13/08/2010 17:47
A 65-year-old white woman presented with a 6-month history of a slowly enlarging plaque of alopecia localized to the frontal scalp. She denied associated pain or pruritus. On cutaneous examination, there was a 6-cm, mildly indurated, slightly erythematous and yellow plaque with multiple overlying telangiectasias on the right anterior scalp (). A central punch biopsy specimen was taken.
13/08/2010 17:47
A 65-year-old white woman presented with a 6-month history of a slowly enlarging plaque of alopecia localized to the frontal scalp. She denied associated pain or pruritus. On cutaneous examination, there was a 6-cm, mildly indurated, slightly erythematous and yellow plaque with multiple overlying telangiectasias on the right anterior scalp (). A central punch biopsy specimen was taken.
How to diagnose nonpigmented skin tumors: A review of vascular structures seen with dermoscopy: Part I. Melanocytic skin tumors
13/08/2010 17:47
Dermoscopy is a noninvasive tool that can be helpful in the diagnosis of nonpigmented skin tumors. This is because dermoscopy permits the visualization of key vascular structures that are usually not visible to the naked eye. Much work has concentrated on the identification of specific morphologic types of vessels that allow a classification into melanocytic versus nonmelanocytic and benign versus malignant nonpigmented skin tumors. Among a broad spectrum of different types of vascular patterns, [...]
13/08/2010 17:47
Dermoscopy is a noninvasive tool that can be helpful in the diagnosis of nonpigmented skin tumors. This is because dermoscopy permits the visualization of key vascular structures that are usually not visible to the naked eye. Much work has concentrated on the identification of specific morphologic types of vessels that allow a classification into melanocytic versus nonmelanocytic and benign versus malignant nonpigmented skin tumors. Among a broad spectrum of different types of vascular patterns, [...]
How to diagnose nonpigmented skin tumors: A review of vascular structures seen with dermoscopy: Part II. Nonmelanocytic skin tumors
13/08/2010 17:47
Nonmelanoma skin cancer refers to a broad class of tumors, including actinic keratosis, basal cell carcinoma, and squamous cell carcinoma, and as a group these are the most frequent cancers occurring in light skinned humans. In contrast to the rarity of amelanotic melanoma, nonmelanoma skin cancer commonly lacks pigmentation. Although these tumors rarely cause death related to metastases, they commonly destroy underlying tissues and should be removed at the earliest possible stage. Dermoscopy im [...]
13/08/2010 17:47
Nonmelanoma skin cancer refers to a broad class of tumors, including actinic keratosis, basal cell carcinoma, and squamous cell carcinoma, and as a group these are the most frequent cancers occurring in light skinned humans. In contrast to the rarity of amelanotic melanoma, nonmelanoma skin cancer commonly lacks pigmentation. Although these tumors rarely cause death related to metastases, they commonly destroy underlying tissues and should be removed at the earliest possible stage. Dermoscopy im [...]
Revisiting nephrogenic systemic fibrosis in 6 kidney transplant recipients: A single-center experience
13/08/2010 17:47
Background: Nephrogenic systemic fibrosis (NSF) is a fibrotic disorder occurring in patients with renal dysfunction. Exposure to gadolinium (Gd)-based contrast agents (GBCAs) during renal impairment is associated with development of NSF.Methods: A cross-referenced search of kidney transplantation and radiology databases at a single institution revealed the prevalence of NSF in the transplant population. Clinical records and skin biopsy specimens from 6 patients with kidney transplant given a dia [...]
13/08/2010 17:47
Background: Nephrogenic systemic fibrosis (NSF) is a fibrotic disorder occurring in patients with renal dysfunction. Exposure to gadolinium (Gd)-based contrast agents (GBCAs) during renal impairment is associated with development of NSF.Methods: A cross-referenced search of kidney transplantation and radiology databases at a single institution revealed the prevalence of NSF in the transplant population. Clinical records and skin biopsy specimens from 6 patients with kidney transplant given a dia [...]
Reply
05/08/2010 12:03
To the Editor: I am flattered by the interest taken in my short letter by Dr Dzubow, a lion of dermatologic surgery. I was unaware of the article by Breuninger, because it was published in a journal that is not indexed in Medline/PubMed. The intracutaneous butterfly suture, however, is fundamentally different from the set-back suture in that its orientation, as Dzubow notes, is horizontal. This increases the theoretical risk of tissue necrosis and results in less dramatic wound eversion. The but [...]
05/08/2010 12:03
To the Editor: I am flattered by the interest taken in my short letter by Dr Dzubow, a lion of dermatologic surgery. I was unaware of the article by Breuninger, because it was published in a journal that is not indexed in Medline/PubMed. The intracutaneous butterfly suture, however, is fundamentally different from the set-back suture in that its orientation, as Dzubow notes, is horizontal. This increases the theoretical risk of tissue necrosis and results in less dramatic wound eversion. The but [...]