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Journal of Cutaneous Medicine and Surgery

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https://www.readbyqxmd.com/read/28821219/early-congenital-syphilis-recognising-symptoms-of-an-increasingly-prevalent-disease
#1
Nupur U Patel, Elias Oussedik, Erin T Landis, Lindsay C Strowd
BACKGROUND: Congenital syphilis (CS) is an infectious disease resulting from transplacental transmission of Treponema pallidum spirochetes from an infected mother to fetus during pregnancy. While uncommon, CS has shown an increased incidence in Canada and the United States since 2001 and 2012, respectively. CASE REPORT: We present the case of a 5-week-old female infant with blistering rash on the palms and soles. The infant displayed decreased movement of the left upper extremity, clinically consistent with Parrot pseudoparalysis...
August 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28817957/case-report-of-onychomycosis-and-tinea-corporis-due-to-microsporum-gypseum
#2
Jesse M Fike, Ramya Kollipara, Suzanne Alkul, Cloyce L Stetson
BACKGROUND: Microsporum gypseum is a geophilic dermatophyte that colonises keratinous substances in the soil. Fur-bearing animals carry this dermatophyte but are rarely infected. Human infection can be acquired from the soil, carrier or infected animals, and rarely other humans. M gypseum is an uncommon cause of cutaneous infection in humans and typically manifests as tinea corporis, tinea barbae, and tinea capitis. Onychomycosis is rarely caused by M gypseum. CASE SUMMARY: We present a case of a 32-year-old white man who presented with a red scaly rash and nail dystrophy after adopting a pet rat 10 years prior to presentation...
August 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28793799/undergraduate-dermatology-education-in-canada-a-national-survey
#3
Angela Hu, Ron Vender
BACKGROUND: Canadian dermatology curriculum was reviewed in 1983, 1987, 1996, and 2008. All these surveys highlighted the disproportionately low level of dermatology teaching in relation to the significant amount of skin disease seen by physicians. Since the official adoption and dissemination of the Canadian Professors of Dermatology (CPD) core curriculum and competencies, there has been no assessment of how these changes have influenced dermatology curriculum. OBJECTIVE: This survey gathered information on the current status of undergraduate dermatology education across Canadian medical schools...
August 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28789566/treatment-changes-in-patients-with-moderate-to-severe-psoriasis-a-retrospective-chart-review
#4
Jaclyn A Smith, Brooke Wehausen, Irma Richardson, Yang Zhao, Yunfeng Li, Vivian Herrera, Steven R Feldman
BACKGROUND: Psoriasis treatment involves topical medications, oral medications, phototherapy, and/or biologics. The treatments used depend on a myriad of factors that change over time. OBJECTIVE: To characterise the frequency of and reasons for treatment changes in patients with moderate to severe psoriasis. METHODS: A chart review examined treatment changes at 902 visits by 116 patients seen between January 1, 2010, and June 30, 2015, for moderate to severe psoriasis and the physicians' justifications for those changes...
August 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28750558/case-report-diagnosis-of-a-rare-plaque-like-dermal-fibroma-successfully-treated-with-mohs-surgery
#5
Pavandeep Gill, John Arlette, Carolyn J Shiau, Marie S Abi Daoud
BACKGROUND: CD34-positive plaque-like dermal fibroma (PDF) is a poorly characterised benign dermal neoplasm that has a wide differential diagnosis. It can be mistaken for other entities on superficial biopsy and be overtreated, leading to unnecessary worry and extensive surgery. OBJECTIVE: To report on an uncommon presentation of this entity, the histopathologic differential diagnosis of PDF, and a novel treatment method. METHODS: Clinical and histopathological information was obtained for a PDF lesion on a 75-year-old man...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28735569/treatment-of-moderate-to-severe-psoriasis-with-high-dose-450-mg-secukinumab-case-reports-of-off-label-use
#6
Jennifer Beecker, Jiyeh Joo
Treatment of moderate to severe psoriasis often requires systemic therapy, including biologics. Partial response to biologics and relapses are commonly managed with dose escalation. Secukinumab is a relatively new biologic that is currently used to treat moderate to severe psoriasis. There has been no literature published on dose escalation of secukinumab. This article describes the off-label use of a higher dose of secukinumab (450 mg every 4 weeks) instead of the standard dosing (300 mg every 4 weeks) in 2 patients with moderate to severe psoriasis...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28719980/distinguishing-epidermolysis-bullosa-acquisita-from-bullous-pemphigoid-without-direct-immunofluorescence
#7
Kerry M Gardner, Richard I Crawford
BACKGROUND: It has been postulated that periodic acid-Schiff staining of basement membrane can predict direct immunofluorescence patterns seen in epidermolysis bullosa acquisita and bullous pemphigoid. It has also been suggested that the type of inflammatory infiltrate or presence of fraying of basal keratinocytes may differentiate these two conditions. OBJECTIVE: In this study, we aimed to confirm these observations. METHODS: We reviewed 13 cases of direct immunofluorescence-confirmed epidermolysis bullosa acquisita and 19 cases of direct immunofluorescence-confirmed bullous pemphigoid, all with a subepidermal blister in the routinely processed specimen...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28712310/primary-cutaneous-peripheral-t-cell-lymphoma-in-a-sporotrichoid-pattern-a-case-report
#8
Daniel J Lewis, Harina Vin, Tiffany Hinojosa, Michael T Tetzlaff, Bouthaina S Dabaja, Madeleine Duvic
We present the extraordinary case of a 72-year-old man with a history of primary cutaneous peripheral T-cell lymphoma not otherwise specified (pcPTCL-NOS) previously controlled with topical agents who developed tumours in a sporotrichoid pattern. Culture of the tumours was negative, and histopathology showed findings consistent with recurrent pcPTCL. The tumours were successfully treated with localised radiation therapy. Sporotrichoid lesions are an extremely rare and atypical presentation of cutaneous lymphoma, with only 2 other cases reported in the literature...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28705050/association-of-isotretinoin-with-depression-and-suicide-a-review-of-current-literature
#9
João Miguel Oliveira, Gonçalo Sobreira, Jorge Velosa, Diogo Telles Correia, Paulo Filipe
Acne vulgaris, a condition that can affect people at any age, is the most common cause of referral to a dermatologist. Isotretinoin (ITT) is the most effective treatment available, but serious adverse effects, including a possible association with depression and suicide, limit its use. We review the current literature regarding the association of ITT with depression and suicide. Case reports and database studies show a clear association, and this association is biologically plausible. Although prospective studies have opposite results, limitations make them unsuitable to identify a subgroup of patients who may be at risk of developing depression or suicidal ideation with ITT...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28689448/metastatic-melanoma-in-sentinel-node-negative-patients-the-ottawa-experience
#10
Chloe E Ward, Jennifer L MacIsaac, Caroline E Heughan, Louis Weatherhead
BACKGROUND: Lymph node involvement is a major independent prognostic factor for survival in patients with malignant melanoma. Sentinel lymph node biopsy (SLNB) detection of microscopic nodal melanoma has been shown to improve both 5-year survival and 5-year disease-free survival. OBJECTIVE: To determine the rate of metastatic melanoma in SLNB-negative patients at long-term follow-up. METHODS: Study subjects include all 152 patients who had a negative SLNB and were followed at the Ottawa Regional Cancer Centre (ORCC) between 1999 and 2004...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28689431/what-is-known-about-the-psychodermatology-clinic-model-of-care-a-systematic-scoping-review
#11
Stephanie Zhou, Ilya Mukovozov, An-Wen Chan
BACKGROUND: Psychodermatology focuses on the interaction between skin and mental health. Existing research discusses the recognition and treatment of these disorders. However, little is known about the operational structure of subspecialised psychodermatology clinics. OBJECTIVE: To identify literature on the structure and logistics of delivering a psychodermatology service. METHODS: A systematic search of MEDLINE, PsycINFO, Embase, and Google Scholar was performed...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28685596/amelanotic-lentigo-maligna-melanoma-mohs-surgery-as-the-definitive-treatment-of-an-invisible-tumour
#12
Marisa Grace Ponzo, Richard Ian Crawford, Irèn Kossintseva
Amelanotic lentigo maligna melanoma represents <2% of melanomas. Diagnosis is delayed owing to the lack of lesion pigmentation and advanced disease at presentation. Excision with appropriate margins is the treatment standard, but the starting point for such margins is often unclear. We describe 2 patients with amelanotic melanoma treated by Mohs micrographic surgery (MMS) that would not have been cleared by wide local excision alone and provide an extensive review of the literature. Both patients presented with histologic diagnoses of malignant melanoma, one with a barely perceptible biopsy site scar on the left infraorbital cheek/lower eyelid (Breslow 1...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28673091/review-of-primary-cutaneous-mucinoses-in-nonlupus-connective-tissue-diseases
#13
Russell X Wong, Justin C Chia, Richard M Haber
Lichen myxedematosus is an idiopathic, cutaneous mucinosis with 2 clinicopathologic subsets. There is the generalised papular and sclerodermoid form, more properly termed scleromyxedema, and the localised papular form. We report the first case, to our knowledge, of lichen myxedematosus in association with rheumatoid arthritis as well as a case in association with dermatomyositis. An up-to-date literature review on cutaneous mucinoses and connective tissue diseases, excluding the common association of primary and secondary mucinoses with systemic lupus erythematosus, was also performed...
July 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28662584/necrolytic-migratory-erythema-a-forgotten-paraneoplastic-condition
#14
Catherine Tremblay, Isabelle Marcil
BACKGROUND: Necrolytic migratory erythema (NME) is most commonly a paraneoplastic condition. It is the dermatologic manifestation classically associated with glucagonoma pancreatic neuroendocrine tumour. Glucagonoma syndrome has been defined by the constellation of secreting tumour associated with overproduction by the α-cells in the pancreatic islets of Langerhans, abnormally elevated blood level of glucagon, and skin findings of NME. OBJECTIVE: Although rare, all dermatologists must know and recognise NME promptly to request useful investigations for the diagnosis of this characteristic neuroendocrine tumour...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28658971/case-series-a-kindred-with-eruptive-vellus-hair-cysts-and-systemic-features
#15
Marisa G Ponzo, Margot I Van Allen, Linlea Armstrong, Magdalena Martinka, Jan P Dutz
Eruptive vellus hair cysts (EVHCs) often occur on the trunk and limbs. Facial involvement is uncommon. Autosomal dominant inheritance has been described, but associated extracutaneous anomalies have not. We describe a 4-patient kindred presenting with multiple facial EVHCs and an association of preauricular pits, lipomas, joint hypermobility, and cardiac defects. Histopathologic examination confirmed the diagnosis of EVHCs in 3 affected individuals. We propose that facial EVHCs may indicate the presence of an inherited autosomal dominant disorder with extracutaneous manifestations...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28656779/primary-cutaneous-histoplasma-capsulatum-infection-in-a-patient-treated-with-fingolimod-a-case-report
#16
Gabrielle M Veillet-Lemay, Michael A Sawchuk, Nordau D Kanigsberg
Fingolimod is an immune-modulating drug used in the treatment of multiple sclerosis. Histoplasma capsulatum is a dimorphic fungus that can infect humans. Infection with the pathogen typically affects the lungs, but it is usually asymptomatic and self-limited. However, immunocompromised patients infected with the pathogen can present atypically, including the development of primary cutaneous lesions. We describe an interesting clinical case of a cutaneous H capsulatum infection in a patient treated with fingolimod...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28639463/adverse-drug-reactions-and-cutaneous-manifestations-associated-with-anticoagulation
#17
Trang T Vu, Melinda Gooderham
Anticoagulants are amongst the most commonly prescribed medications worldwide. Although rare, localised and systemic drug reactions have been reported with anticoagulants that can lead to significant morbidity and mortality. Some of the first signs of drug reactions to anticoagulants are cutaneous changes that, when recognised early, can prevent significant complications. Dermatologists should be aware of these changes to make an early and accurate diagnosis. This is particularly important in instances of skin-induced necrosis caused by systemic toxicity to anticoagulants...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28639462/onychomycosis-in-the-21st-century-an-update-on-diagnosis-epidemiology-and-treatment
#18
Aditya K Gupta, Sarah G Versteeg, Neil H Shear
Onychomycosis accounts for 50% of all nail disease cases and is commonly caused by dermatophytes. Diabetes, human immunodeficiency virus, immunosuppression, obesity, smoking, and advancing age are predisposing factors of this fungal infection. Potassium hydroxide and culture are considered the current standard for diagnosing onychomycosis, revealing both fungal viability and species identification. Other diagnostic tests currently available include periodic acid-Schiff staining, polymerase chain reaction techniques, and fluorescent staining...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28639459/approach-to-the-management-of-patients-with-hidradenitis-suppurativa-a-consensus-document
#19
Afsaneh Alavi, Charles Lynde, Raed Alhusayen, Marc Bourcier, Isabelle Delorme, Ralph George, Melinda Gooderham, Wayne Gulliver, Sunil Kalia, Danielle Marcoux, Yves Poulin
BACKGROUND: Hidradenitis suppurativa (HS) is a painful, debilitating, and poorly understood condition, which is suboptimally diagnosed, managed, and treated. Evidence supporting various treatment modalities is sparse. OBJECTIVES: To incorporate scientific evidence and expert opinions to develop useful guidance for the evaluation and management of patients with HS. METHODS: An expert panel of Canadian dermatologists and surgeons developed statements and recommendations based on available evidence and clinical experience...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28639453/atypical-primary-cutaneous-rosai-dorfman-disease-a-case-report
#20
Anna E Kinio, Michael A Sawchuk, Melanie Pratt
BACKGROUND: Rosai Dorfman disease (RDD) is a rare disorder that typically presents with bilateral cervical lymphadenopathy and follows a benign course. OBJECTIVE: We present a case of late-onset atypical primary cutaneous RDD that is resistant to treatment modalities described in the literature. METHODS: Case report. RESULTS: An 84-year-old woman presented with a 7-year history of cutaneous lesions histologically consistent with RDD...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
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