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Journal of Clinical and Aesthetic Dermatology

Ani Tajirian, Michelle Tsui
OBJECTIVE: Following Mohs surgery, medium-to-large defects on the central forehead can often be complicated to surgically reconstruct. In this paper, the authors discuss possible central forehead reconstructions and report their successful experience employing a simple primary vertical linear closure with a special technique to demarcate forehead rhytides rather than performing an overly complicated flap or graft. CASE REPORT: The patient was a 57-year-old man who presented with a broad superficial basal cell carcinoma that required treatment with Mohs surgery...
August 2016: Journal of Clinical and Aesthetic Dermatology
Eric Ehrsam, Joseph R Kallini, Damien Lebas, Amor Khachemoune, Philippe Modiano, Hervé Cotten
Fully regressive melanoma is a phenomenon in which the primary cutaneous melanoma becomes completely replaced by fibrotic components as a result of host immune response. Although 10 to 35 percent of cases of cutaneous melanomas may partially regress, fully regressive melanoma is very rare; only 47 cases have been reported in the literature to date. AH of the cases of fully regressive melanoma reported in the literature were diagnosed in conjunction with metastasis on a patient. The authors describe a case of fully regressive melanoma without any metastases at the time of its diagnosis...
August 2016: Journal of Clinical and Aesthetic Dermatology
Orit Markowitz, Michelle Schwartz
Immunosuppressed transplant recipients have increased risk for the development of basal cell carcinoma skin cancers. While oral vismodegib therapy has been successful in treating locally advanced basal cell tumors, few studies document its use and efficacy in organ transplant patients. In this immunocompromised population, topical imiquimod 5% cream has been shown to be an effective and well-tolerated option for superficial and nodular basal cell carcinomas. To the authors' knowledge, no data documents the use of optical coherence tomography, a noninvasive imaging technique, to monitor progress of such combined therapies on in vivo skin...
August 2016: Journal of Clinical and Aesthetic Dermatology
James Q Del Rosso
Topical antifungal management of toenail onychomycosis has been fraught with several therapeutic challenges including difficulty gaining access to the site of infection and the need for prolonged durations of therapy. In addition, there has been a marked lack of information on the impact of toenail polish application on drug penetration after application. This article reviews available data from studies evaluating the effect of nail polish on antifungal drag penetration using ex vivo laboratory models with cadaver fingernail plates with both tavaborole 5% solution and efinaconazole 10% solution...
August 2016: Journal of Clinical and Aesthetic Dermatology
Gary Goldenberg, Julien Lanoue, Joanna Dong
Conventional oral therapies for psoriasis, including methotrexate, cyclosporine, and acitretin, have generally unfavorable safety profiles and are not ideal for long-standing use. Thus, new oral therapies are necessary for patients with more moderate disease, patients who prefer oral treatments to injectable biologies, and patients who failed conventional therapies. The authors review here the clinical and safety evidence of phosphodiesterase 4 inhibitor, apremilast, janus kinase inhibitors, including tofacitinib, and fumarie acid esters as additional options in oral psoriasis therapy...
August 2016: Journal of Clinical and Aesthetic Dermatology
Pavel V Chernyshov, Roger C Ho, Fiorella Monti, Anna Jirakova, Svitlana S Velitchko, Jana Hercogova, Erica Neri
BACKGROUND: Atopic dermatitis has a significant impact on quality of life of children and families. OBJECTIVE: It is important to assess gender differences in health-related quality of life in children with atopic dermatitis in order to effectively use health-related quality of life results. METHODS: Children 5- to 16-years of age with atopic dermatitis from Italy, Singapore, Czech Republic, and Ukraine were divided into two groups (boys and girls)...
August 2016: Journal of Clinical and Aesthetic Dermatology
Hilary Baldwin, Daisy Blanco, Charles McKeever, Nelly Paz, Ynca Nina Vasquez, John Quiring, Carolyn Enloe, Emily De León, Nathan Stasko
OBJECTIVE: To compare efficacy, tolerability, and safety of two concentrations of topical SB204 and vehicle twice daily for 12 weeks in the treatment of acne vulgaris. DESIGN: Randomized, double-blind, placebo-controlled, three-arm, Phase 2 study. SETTING: Dominican Republic, Panama, and Honduras. PARTICIPANTS: Subjects with acne, age 12 to 40, with 25 to 70 noninflammatory lesions, 20 to 40 inflammatory lesions, and a baseline Investigator's Global Assessment score of mild, moderate, or severe...
August 2016: Journal of Clinical and Aesthetic Dermatology
Jason M Hirshburg, Petra A Kelsey, Chelsea A Therrien, A Carlo Gavino, Jason S Reichenberg
Finasteride and dutasteride, both 5-alpha reductase inhibitors, are considered first-line treatment for androgenetic hair loss in men and used increasingly in women. In each case, patients are expected to take the medications indefinitely despite the lack of research regarding long-term adverse effects. Concerns regarding the adverse effects of these medications has led the United States National Institutes of Health to add a link for post-finasteride syndrome to its Genetic and Rare Disease Information Center...
July 2016: Journal of Clinical and Aesthetic Dermatology
Richard R Winkelmann, Aaron S Farberg, Natalie Tucker, Richard White, Darrell S Rigel
BACKGROUND: Early detection and subsequent management of melanoma are critical for patient survival. New technologies have been developed to augment clinician analysis of suspicious pigmented skin lesions. OBJECTIVE: To determine how information provided by a multispectral digital skin lesion analysis device affects the biopsy decisions of international dermatologists following clinical and dermoscopic pigmented skin lesion evaluation. METHODS: Participants at a dermoscopy conference in Vienna, Austria, were shown 12 clinical and dermoscopic images of pigmented skin lesions (2 melanomas in situ, 3 invasive melanomas, and 7 low-grade dysplastic nevi) previously analyzed by multispectral digital skin lesion analysis...
July 2016: Journal of Clinical and Aesthetic Dermatology
Tamara Agnew, Gareth Furber, Matthew Leach, Leonie Segal
OBJECTIVE: Acne vulgaris is a dynamic, complex condition that is notoriously difficult to evaluate. The authors set out to critically evaluate currently available measures of acne severity, particularly in terms of suitability for use in clinical trials. DESIGN: A systematic review was conducted to identify methods used to measure acne severity, using MEDLINE, CINAHL, Scopus, and Wiley Online. Each method was critically reviewed and given a score out of 13 based on eight quality criteria under two broad groupings of psychometric testing and suitability for research and evaluation...
July 2016: Journal of Clinical and Aesthetic Dermatology
Giuseppe Micali, Peter Arne Gerber, Francesco Lacarrubba, Gregor Schäfer
Rosacea is a chronic inflammatory disease that can present with a variety of cutaneous symptoms. Erythematotelangiectatic rosacea is a subtype characterized by flushing (transient erythema), persistent central facial erythema (background erythema), and telangiectasias. The severity of individual symptoms differs in each patient, which can complicate the selection of an appropriate treatment strategy. Evaluation of these specific symptoms has been greatly improved by the routine use of diagnostic tools such as (video) dermatoscopy...
July 2016: Journal of Clinical and Aesthetic Dermatology
Peter W Hashim, John K Nia, Skylar Singer, Gary Goldenberg
OBJECTIVES: To evaluate the safety and efficacy of ingenol mebutate 0.05% gel after cryosurgery versus cryosurgery alone for the treatment of hypertrophic and nonhypertrophic actinic keratosis on the dorsal hands. DESIGN: Investigator-blinded split arm study. SETTING: Academic institution. PARTICIPANTS: Sixteen subjects with actinic keratoses on dorsal hands. RESULTS: There was a mean reduction in the number of hypertrophic actinic keratosis lesions adjusted for baseline in ingenol mebutate-treated versus control group of -4...
July 2016: Journal of Clinical and Aesthetic Dermatology
Lotus Mallbris, Julian Davies, Andrew Glasebrook, Ying Tang, Wolfgang Glaesner, Brian J Nickoloff
In recent years, a large number of therapeutic monoclonal antibodies have come to market to treat a variety of conditions including patients with immune-mediated chronic inflammation. Distinguishing the relative clinical efficacy and safety profiles of one monoclonal antibody relative to another can be difficult and complex due to different clinical designs and paucity of head-to-head comparator studies. One distinguishing feature in interpreting clinical trial data by dermatologists may begin by determining whether a monoclonal antibody is fully human or humanized, which can be discerned by the generic name of the drug...
July 2016: Journal of Clinical and Aesthetic Dermatology
David N Lortscher, Philip R Cohen, Carolyn A Bangert, Taraneh Paravar
BACKGROUND: Nodular scleroderma, also known as keloidal scleroderma, is a rare variant of systemic sclerosis. PURPOSE: The clinical features, pathologic findings and postulated pathogenesis of nodular scleroderma are discussed. METHODS: A woman with previously undiagnosed systemic sclerosis who presented with nodular scleroderma is described. Using the PubMed database, a literature search was performed on keloidal scleroderma, nodular scleroderma, and systemic sclerosis...
June 2016: Journal of Clinical and Aesthetic Dermatology
Srinivas Sai A Kondapalli, Craig N Czyz, Andrew W Stacey, Kenneth V Cahill, Jill A Foster
PURPOSE: Kaolin is a mineral shown to be effective in controlling hemorrhage when combined with standard gauze and applied to wounds. This study investigates the application of kaolin to control intraoperative bleeding and promote wound healing in eyelid surgery. METHODS: This prospective, randomized, double-blind study recruited patients who underwent eyelid surgery. Following skin incision, kaolin-impregnated gauzewas placed in one eyelid wound bed and cotton gauze in the other, then removed...
June 2016: Journal of Clinical and Aesthetic Dermatology
Birgit N Khandalavala, Melissa Voutsalath Do
OBJECTIVE: Hidradenitis suppurativa is associated with obesity and metabolic syndrome, and a hormonal component has been implicated. Finasteride is an anti-androgenic agent used for benign prostatic hypertrophy, androgenic alopecia, and, in females, hirsutism. Finasteride is an inhibitor of type II5 alpha-reductase that reduces dihydrotestosterone levels and appears to alter end-organ sensitivity of the folliculopilosebaceous unit. The objective is to review the use of finasteride for hidradenitis suppurativa...
June 2016: Journal of Clinical and Aesthetic Dermatology
Bárbara Isabel Roque Cunha Ferreira, José Luís Pio Da Costa Abreu, José Pedro Gaspar Dos Reis, Américo Manuel Da Costa Figueiredo
INTRODUCTION AND OBJECTIVE: Psoriasis is a chronic skin disease with a high impact on self-esteem and patients' health-related quality of life. In the last decades some studies have pointed out mental disorders associated with psoriasis and the etiopathogenic mechanisms behind that co-existence. This work compiles psychopathology associated with psoriasis and further analyzes the etiopathogenesis of psoriasis and mental disorders. METHODS: A systematic review of the literature was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and using the "5S" levels of organization of evidence from healthcare research, as previously described...
June 2016: Journal of Clinical and Aesthetic Dermatology
Carl R Thornfeldt, Paul M Thaxton, Carl S Hornfeldt
OBJECTIVE: The efficacy of low-level laser therapy for noninvasive body contouring has been previously demonstrated in clinical trials leading to its market clearance. Subjects achieved these beneficial effects following three weekly low-level laser therapy treatments for two weeks. The objective of this study was to determine if the same aesthetic benefit can be achieved following one weekly low-level laser therapy treatment for six weeks. SETTING: Two private dermatology practices...
June 2016: Journal of Clinical and Aesthetic Dermatology
Joshua B Wilson, Hobart W Walling, Richard K Scupham, Andrew K Bean, Roger I Ceilley, Kirsten E Goetz
INTRODUCTION: Lentigo maligna is a form of in situ melanoma that occurs commonly on sun-exposed skin of middle-aged to elderly adults. Margin-control surgery offers the highest cure rate for lentigo maligna/lentigo maligna melanoma. MATERIALS AND METHODS: Charts from the authors' private office from the 20-year period from January 1986 to December 2005 were reviewed to identify patients with histologically confirmed lentigo maligna or lentigo maligna melanoma treated by staged excision...
June 2016: Journal of Clinical and Aesthetic Dermatology
James Q Del Rosso, Ted Rosen, Diane Thiboutot, Guy F Webster, Richard L Gallo, James J Leyden, Clay Walker, George Zhanel, Lawrence Eichenfield
In this third article of the three-part series, management of skin and soft tissue infections is reviewed with emphasis on new information on methicillin-resistant Staphylococcus aureus. Due to changes in the evolution of methicillin-resistant Staphylococcus aureus clones, previous distinctions between healthcare-acquired methicillin-resistant Staphylococcus aureus and community-acquired methicillin-resistant Staphylococcus aureus are currently much less clinically relevant. Many nosocomial cases of methicillin-resistant Staphylococcus aureus infection are now caused by community-acquired methicillin-resistant Staphylococcus aureus, with changing patterns of antibiotic susceptibility and resistance...
June 2016: Journal of Clinical and Aesthetic Dermatology
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