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American Journal of Clinical Dermatology

Ayman Grada, Vincent Falanga
Chronic skin ulcers are frequently encountered in clinical practice and are often due to very heterogeneous etiologies. Cryofibrinogenemia is an unusual cause of non-healing skin ulcers. It is a small-vessel occlusive vascular disorder that results from the precipitation of cryofibrinogens in plasma. The lack of definitive diagnostic criteria means cryofibrinogenemia remains an under-diagnosed entity that causes significant morbidity. One of the most common manifestations of cryofibrinogenemia is skin ulceration...
October 12, 2016: American Journal of Clinical Dermatology
Vidhi V Shah, Marshall B Kapp, Stephen E Wolverton
Malpractice risk is a common source of concern for the practicing physician. Dermatologists experience fewer lawsuits than most other specialists in medicine, but the risk is not negligible. All physicians should familiarize themselves with areas of potential risk and avoid medico-legal pitfalls. We present Part I of a two-part series addressing medico-legal questions common to most practitioners that cause a great deal of anxiety. Part I will focus upon risk management and prevention of future malpractice lawsuits, and Part II deals with suggestions and guidance once a lawsuit occurs...
October 12, 2016: American Journal of Clinical Dermatology
Lina I Naga, Tina S Alster
Tattoo art has been around for thousands of years in every culture and is currently flourishing in all age groups, social classes, and occupations. Despite the rising popularity of tattoos, demand for their removal has also increased. While various treatments, including surgical excision, dermabrasion, and chemical destruction have historically been applied, over the past 2 decades, lasers have revolutionized the way tattoos are treated and have become the gold standard of treatment. To achieve optimal cosmetic outcome of treatment, lasers emitting high energies and short pulses are required to adequately destroy tattoo ink...
October 8, 2016: American Journal of Clinical Dermatology
AnneLiese Smylie, Neel Malhotra, Alain Brassard
Relapsing polychondritis, or RP, is a rare connective tissue disease characterized by relapsing-remitting destructive inflammation of the cartilaginous and other proteoglycan-rich structures in the body. Given the relatively low incidence of RP, a concise clinically relevant guide, focusing on the cutaneous manifestations of this serious disease, is lacking. In this review, we provide the dermatologist with an approach to diagnosing RP and a guide to its initial work-up, and management. We close with an overview of the currently available treatment modalities for RP...
October 1, 2016: American Journal of Clinical Dermatology
Matthew Paul Stephany, Stella Chung, Marc Zachary Handler, Nancy Stefanie Handler, Glenn A Handler, Robert A Schwartz
No abstract text is available yet for this article.
October 1, 2016: American Journal of Clinical Dermatology
Jessica Mounessa, Talayesa Buntinx-Krieg, Rosie Qin, Cory A Dunnick, Robert P Dellavalle
The incidence of malignant melanoma (MM) continues to rise in the United States. While sun protection and full body skin examinations remain the mainstay of preventative care, chemoprevention of the deadly disease has become an increasingly popular field of study. In this focused review, we discuss current findings and analyze the risks and benefits of various agents investigated for the primary and secondary chemoprevention of MM. Such agents include topical retinoids, vitamins, and supplements, Polypodium leucotomas extracts, non-steroidal anti-inflammatory agents (NSAIDs), statins, sunscreens, and field therapy with topical imiquimod for primary and secondary chemoprevention...
September 24, 2016: American Journal of Clinical Dermatology
Ting-Shun Wang, Tsen-Fang Tsai
BACKGROUND: Scalp psoriasis is commonly the initial presentation of psoriasis, and almost 80 % of patients with psoriasis will eventually experience it. OBJECTIVE: Although several systematic reviews and guidelines exist, an up-to-date evidence-based review including more recent progress on the use of biologics and new oral small molecules was timely. METHODS: Of the 475 studies initially retrieved from PubMed and the 845 from Embase (up to May 2016), this review includes 27 clinical trials, four papers reporting pooled analyses of other clinical trials, ten open-label trials, one case series, and two case reports after excluding non-English literature...
September 21, 2016: American Journal of Clinical Dermatology
Mio Nakamura, John Koo
In monosymptomatic hypochondriacal psychosis (MHP), such as delusional infestation (DI), the patient has a fixed, false, encapsulated belief associated with tactile hallucinations (TH), most commonly formication, which is defined as cutaneous sensations of crawling, stinging, biting, etc., without evidence of infestation. Drug-induced TH should be considered in patients with suspected MHP. Although recreational drugs such as cocaine, amphetamines, and narcotics are well known to induce TH, many busy practicing dermatologists may not be familiar with other types of medications that can induce TH...
September 9, 2016: American Journal of Clinical Dermatology
Olivier Espitia, Brigitte Dréno, Elisabeth Cassagnau, Quentin Didier, Thibaut Quillard, Christelle Nicol, Yann Le Bouch, Bernard Planchon, Marc-Antoine Pistorius
Although exercise-induced vasculitis (EIV) is usually misdiagnosed, it is not uncommon. Occurring mostly after prolonged exercise, especially in hot weather, EIV is an isolated cutaneous vasculitis with stereotypical presentation. This article reviews the clinical characteristics, treatments, and outcomes of EIV based on the published literature. We report 99 patients who developed EIV after walking, dancing, swimming, or hiking especially during hot weather, including the records of 16 patients with EIV treated at our hospital from 2007 to 2015...
September 3, 2016: American Journal of Clinical Dermatology
Jonathan I Silverberg, Keiki Hinami, William E Trick, David Cella
BACKGROUND: Itch is a well-established symptom in cutaneous disease. However, little is known about the burden of itch outside the dermatology setting. PURPOSE: To determine the prevalence and impact of itch on quality of life (QOL) in the general internal medicine setting. METHODS: We performed a cross-sectional study of 2076 adults from an outpatient general internal medicine clinic, using an audio computer-assisted self-administered interview...
August 12, 2016: American Journal of Clinical Dermatology
Eric Laurent Maranda, Megan Smith, Austin H Nguyen, Vivek N Patel, Lawrence A Schachner, Jimenez J Joaquin
BACKGROUND: Pityriasis lichenoides (PL) is a dermatologic disorder that manifests in either the acute (pityriasis lichenoides et varioliformis acuta) or the chronic form (pityriasis lichenoides chronica, also known as parapsoriasis chronica). Traditional first-line therapy consists of corticosteroids or antibiotics; however, these treatments are often accompanied with multiple side effects and may be ineffective. OBJECTIVE: The goal of this study was to review the use of phototherapy for treating PL in the pediatric population...
August 8, 2016: American Journal of Clinical Dermatology
Alexander Egeberg, Joseph F Fowler, Gunnar H Gislason, Jacob P Thyssen
BACKGROUND: Emerging data suggest that rosacea is associated with several comorbidities; however, the causes of mortality in patients with rosacea have not yet been investigated. OBJECTIVE: We evaluated all-cause and cause-specific death rates in patients with rosacea in a population-based Danish cohort study. METHODS: All Danish individuals aged ≥18 years between 1 January 1997 and 31 December 2012 with rosacea diagnosed by hospital dermatologists were linked in nationwide registers and compared with age- and sex-matched general-population subjects (1:5 ratio)...
August 1, 2016: American Journal of Clinical Dermatology
Carolyn Stull, Shoshana Grossman, Gil Yosipovitch
Pruritus is a common and significant symptom among patients with psoriasis. Pruritus is often present beyond the borders of psoriatic plaques, and frequently affects the scalp and genital regions. Psoriatic itch may be severe and can profoundly affect quality of life and sleep, even in the context of mild-to-moderate disease. These features often make the treatment of psoriatic pruritus challenging. However, there are a variety of effective topical and systemic treatment modalities available to address this symptom...
July 26, 2016: American Journal of Clinical Dermatology
Esther S Kim, Karly P Garnock-Jones, Susan J Keam
Subcutaneous adalimumab (Humira(®)) is a tumour necrosis factor-α blocker that is the only approved agent for the treatment of moderate to severe hidradenitis suppurativa (HS) in several countries worldwide. This article reviews the clinical efficacy and safety of subcutaneous adalimumab in patients with moderate to severe HS. In clinical trials (PIONEER I and II), a greater proportion of adalimumab than placebo recipients reached HS clinical response (HiSCR) at week 12. The main secondary endpoints, such as the proportion of patients with an abscess and inflammatory nodule count of ≤2 at week 12, were significantly greater with adalimumab than with placebo in PIONEER II, but not in PIONEER I...
October 2016: American Journal of Clinical Dermatology
Mathew Paul Stephany, Stella Chung, Marc Zachary Handler, Nancy Stefanie Handler, Glenn A Handler, Robert A Schwartz
Shiitake mushroom dermatitis is a cutaneous reaction caused by the consumption of raw or undercooked shiitake mushrooms. Symptoms include linear erythematous eruptions with papules, papulovesicles or plaques, and severe pruritus. It is likely caused by lentinan, a heat-inactivated beta-glucan polysaccharide. Cases were initially reported in Japan but have now been documented in other Asian countries, North America, South America, and Europe, as this mushroom is now cultivated and consumed worldwide. Shiitake mushroom dermatitis may result from mushroom ingestion or from handling, which can result in an allergic contact dermatitis...
October 2016: American Journal of Clinical Dermatology
Gary K Yang, Sarah Cao, Ahmed Kayssi, Andrew D Dueck, Afsaneh Alavi
BACKGROUND: Venous leg ulcers (VLUs) are common but challenging health problems. Better understanding of the risk factors involved in delayed healing of VLUs may therefore guide individualized treatment plans to improve patient outcomes. OBJECTIVE: We sought to identify the risk factors associated with delayed healing of VLUs in patients seen at a tertiary academic wound care clinic. METHODS: A retrospective analysis of 554 patients who presented to the Toronto Regional Wound Healing Clinic for VLUs in a 3-year period was performed...
October 2016: American Journal of Clinical Dermatology
Feras M Al-Ghazawi, Michele L Ramien, Alain Brassard, Neil H Shear, Jennifer Beecker
Dermatologists face a wide range of pain control challenges in daily practice, from the transient pain of dermatologic surgery to the persistent pain that plagues some chronic dermatologic conditions. Although the pathophysiology of pain is well described and the profound impact of dermatological pain on patients' quality of life is well appreciated, there is an identified need for clear therapeutic plans for providing symptomatic pain relief of common painful dermatoses. In this paper, we will review and clearly outline approaches to pain management of a number of common painful dermatoses such as herpes zoster and post-herpetic neuralgia, ulcers, oral dermatoses, dysesthesias, and many others...
October 2016: American Journal of Clinical Dermatology
Jeremy Udkoff, Philip R Cohen
Amyopathic dermatomyositis is a rare, idiopathic, connective tissue disease that presents with dermatologic lesions of classic dermatomyositis but lacks the myopathy of this disease. Cutaneous manifestations may include Gottron's sign, heliotrope rash, and characteristic patterns of poikiloderma. There is a substantial risk for developing interstitial lung disease or malignancy in patients with amyopathic dermatomyositis. A literature review of amyopathic dermatomyositis was performed using the PubMed medical database...
October 2016: American Journal of Clinical Dermatology
April W Armstrong, Michael Bukhalo, Andrew Blauvelt
Many of the molecular pathways associated with psoriasis pathogenesis are also involved in host defense mechanisms that protect against common pathogens. Candida can stimulate the production of cytokines that trigger or exacerbate psoriasis, and many systemic psoriasis treatments may put patients at increased risk for developing oral, cutaneous, and genitourinary candidiasis. Therefore, dermatologists should regularly screen patients with psoriasis for signs of Candida infection, and take steps to effectively treat these infections to prevent worsening of psoriasis symptoms...
August 2016: American Journal of Clinical Dermatology
Mai Abdelnabi, Aakash Patel, Monica Rengifo-Pardo, Alison Ehrlich
BACKGROUND: With the variability in health insurance coverage for psoriasis systemic therapies, recent changes in coverage for biologics have yet to be evaluated. PURPOSE: To determine changes in insurance coverage of biologics for moderate-to-severe psoriasis between 2009 and 2014, with a focus on insurance policies as stated in prior authorization (PA) forms, coverage denials, and time course of approval process. METHODS: A retrospective chart review was performed on patients with a diagnosis of psoriasis (International Classification of Diseases [ICD], Ninth Edition, code ICD 696...
August 2016: American Journal of Clinical Dermatology
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