bluuebunny/crossref_metadata_2025 huggingface dataset:
Mycophenolate Mofetil (CellCept®) for Psoriasis: A Two-Center, Prospective, Open-Label Clinical Trial
Authors: Zhou Youwen , Rosenthal Don , Dutz Jan , Ho Vincent
Published: July 2017

Background:

Mycophenolate mofetil (MMF) is an immune suppressant that selectively inhibits activated lymphocytes. Its usefulness in treating psoriasis has not been systematically investigated.

Objective:

To evaluate efficacy and safety of MMF as a monotherapy for psoriasis.

Methods:

This is a two-center, prospective, open-label clinical trial.

Results:

Twenty-three patients with moderate to severe psoriasis [mean psoriasis area and severity index (PASI) of 21.7] were treated with MMF 2–3 g/day for 12 weeks. Eighteen patients completed the study. The PASI was reduced by 24% ( p < 0.001) at 6 weeks, and by 47% ( p < 0.001) at 12 weeks. At the end of the treatment phase, 77% of the patients had significant reduction of PASI while 22% did not respond. The treatment was well tolerated. Five patients experienced mild nausea. One patient each had periorbital edema and pruritus. One patient had transient leukopenia.

Conclusion:

In this noncontrolled trial, the majority of patients with moderate to severe psoriasis responded to mycophenolate mofetil monotherapy with few adverse events. A randomized, controlled trial should be considered to confirm the usefulness of MMF as a monotherapy for psoriasis.
Trends in Invasive Cutaneous Melanoma in Saskatchewan 1970–1999
Authors: Ulmer Marcie J. , Tonita Jon M. , Hull Peter R.
Published: July 2017

Background:

Melanoma incidence rates have increased dramatically in white populations worldwide during the past several decades. A more modest increase has been observed for melanoma-related mortality. Cause-specific and disease-free survivals are related to tumor characteristics, gender, age, and possibly anatomic site. It is difficult to accurately assess these trends without information on tumor thickness that is often unavailable.

Objective:

This study determines trends in melanoma incidence, mortality, and survival in Saskatchewan for a 30-year period, incorporating analysis of tumor thickness.

Methods:

Information about cases of primary cutaneous melanoma for the 30-year period 1970–1999 was obtained from the population-based Saskatchewan Cancer Registry. A 50% random sample of charts was reviewed to collect information about Breslow depth, Clark level, and other demographic data not available from the Registry. Multivariate regression analysis was used to determine the significance of prognostic factors on incidence and five-year relative survival rates.

Results:

The number of patients registered increased dramatically during the study period. The increase was greatest for thin lesions in all age groups. Anatomic site varied by gender. Head and neck tumors showed continual increase in risk with increasing age. Mortality rates in females have been stable over time but increased for males in the 1990s. The prognostic factors that predicted excess mortality at five years were tumor thickness, Clark level, and gender.

Conclusion:

The observed increase in melanoma appears to be real and not the result of increased surveillance or screening. Tumor characteristics (Breslow depth, Clark level) and gender were significant prognostic indicators of five-year excess mortality.
Bilobed Thumbnails with Erythronychia
Authors: McLean Tammy K. , Lane Joshua E. , Scher Richard , Lesher Jack L.
Published: July 2017

Onychodystrophy is a common problem and may have multiple causes, both internal and environmental. We present an unusual nail finding in a gentleman without any identifiable etiology. He and several family members had isolated notching of the thumbnails with a characteristic erythematous band.
Treatment of Onychomycosis: Pros and Cons of Antifungal Agents
Authors: Gupta Aditya K. , Ryder Jennifer E. , Skinner Alayne R.
Published: July 2017

Background:

Antifungal agents are beneficial in the treatment of onychomycosis in the general population, as well as in children, the elderly, and immunocompromised individuals. Special patient populations can be more difficult to treat due to such factors as drug interactions with concomitant medications, adverse events, and poor compliance. In addition, there is limited information about the use of antifungal agents in special populations, e.g., children.

Objective:

The pros and cons of oral and topical antifungal agents are discussed, with focus on special patient populations.

Methods:

We searched MedLine (1966 to April 2003) for clinical studies evaluating the efficacy of oral and topical antifungal agents to treat onychomycosis. The key words used in conjunction with “onychomycosis” include: “terbinafine,” “itraconazole,” “fluconazole,” “amorolfine nail lacquer,” “ciclopirox nail lacquer,” “HIV,” “transplant patients,” “diabetes,” “children,” and “elderly.” Studies were excluded if published in a language other than English.

Results:

Studies have shown that antifungal agents can be of benefit in treating the elderly, children, and immunocompromised individuals (e.g., transplant patients, Down's patients, HIV patients, and diabetics) with onychomycosis.

Conclusion:

The treatment modality of onychomycosis in special patient populations should take into account the clinical presentation of the onychomycosis, the causative organism, patient and physician preference, the concomitant medications that the patient is on, and the potential for adverse events for that patient if antifungal therapy is undertaken.
Scabies by Kenneth Mellanby
Authors: Jackson Robert
Published: July 2017

Background:

Epidemics of scabies are often associated with wars or other times of social upheaval. This was particularly evident during the Second World War when it was estimated that there were one to two million patients with scabies in Great Britain.

Objective:

This article reviews the work of the zoologist Kenneth Mellanby of England and evaluates his contribution to our knowledge of the diagnosis and treatment of scabies in the Second World War.

Conclusion:

Using humans, Mellanby studied the transmission and treatment of this disease. Among his contributions were knowledge of how many mites the average patient had, and where they were located. He clearly noted and described that the scabies rash was not limited to the location of the mites on the body; he attributed the rash in areas with no mites to “a true sensitization.” He found that “fomites were not the major method of transmissions.”
A Review of the Use of Infliximab to Manage Cutaneous Dermatoses
Authors: Gupta Aditya K. , Skinner Alayne R.
Published: July 2017

Background:

Infliximab is a chimeric monoclonal antibody that binds specifically to human tumor necrosis factor-alpha (TNF-α), decreasing the effect of the cytokine in inflammatory diseases.

Objective:

The aim of this study was to review the efficacy and safety of infliximab in the treatment of dermatological diseases.

Methods:

A MEDLINE search (1966–January 2003), using the keyword “infliximab” was performed to find relevant articles pertaining to the use of infliximab in dermatology.

Results:

Infliximab has been used in the following dermatological diseases: psoriasis, Behçet's disease, graft versus host disease, hidradenitis suppurativa, panniculitis, pyoderma gangrenosum, SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome, sarcoidosis, subcorneal pustular dermatosis, Sweet's syndrome, toxic epidermal necrolysis, and Wegener's granulomatosis. There is a generally good safety profile for infliximab, which is similar to that when it is used to treat Crohn's disease and rheumatoid arthritis.

Conclusion:

Although not approved for use in dermatological diseases, there have been numerous reports of the efficacy of infliximab in cutaneous inflammatory diseases. The most promise lies in those diseases that have increased amounts of TNF-α in the cutaneous lesions, such as psoriasis.
Topical Therapy for Peristomal Pyoderma Gangrenosum
Authors: Nybaek Hanne , Olsen A. G. , Karlsmark T. , Jemec G. B. E.
Published: July 2017

Background:

Pyoderma gangrenosum (PG) is an uncommon condition. Literature on the management of peristomal PG (PPG) is sparse. In the absence of randomized controlled trials the reporting of case series is potentially helpful to the management of this uncommon disease.

Objective:

In this study we report our experience with topical corticosteroid therapy for 14 consecutive cases of PPG.

Methods:

A clinical diagnosis PPG was made by a trained dermatologist using the appropriate investigations where necessary.

Results:

The majority of the cases presented were managed with simple topical corticosteroids, occasionally in combination with a change of dressing. In 8/14 (57%) cases ulcer resolution was achieved within 3 months with topical treatment alone or topical treatment plus a change of dressing to a silicone-based product applied directly to the wound under the normal base plate of the stoma bag.

Conclusion:

Our experience suggests that a significant proportion of PPG can be managed by topical treatment alone. The simple topical treatment allows the patient to continue use of stoma care products while minimizing the potential for side effects.
Viral and Nonviral Uses of Imiquimod: A Review
Authors: Gupta Aditya K. , Cherman Andrea M. , Tyring Stephen K.
Published: July 2017

Background:

Imiquimod is a topical immunomodulator that is indicated for the treatment of external genital and perianal warts. This drug has been recently approved for the treatment of actinic keratoses and superficial basal cell carcinoma. There is a growing body of evidence for its effectiveness in treating a variety of other skin conditions.

Objective:

This review examines the role of imiquimod 5% cream in the treatment of skin diseases such as actinic keratoses, basal cell carcinoma, Bowen's disease, lentigo maligna, and extramammary Paget's disease.

Methods:

Published literature containing the words “Imiquimod” or “Aldara” was reviewed and summarized.

Results:

This agent has demonstrated indirect antiviral and antitumor effects in animal models. Although the exact mechanism of action is unknown, imiquimod is an agonist for toll-like receptor (TLR) 7 and is thought to act by inducing cytokines, such as interferon alpha (IFN-α), interleukin-12 (IL-12), and tumor necrosis factor alpha (TNF-α). These cytokines trigger the immune system to recognize the presence of a viral infection or tumor and the associated lesion is ultimately eradicated. Side effects are generally well tolerated with local skin reactions reported most frequently.

Conclusion:

Imiquimod has been shown to be a safe and effective treatment for a variety of skin conditions.
Epidermodysplasia Verruciformis in Two Half Brothers with HIV Infection
Authors: Hu Weimin , Nuovo Gerard , Willen Marlene , Somach Stephen
Published: July 2017

Background:

Epidermodysplasia verruciformis (EV) is a rare disorder characterized by widespread flat and common Verrucae. From 25% to 50% of EV cases are inherited, usually with an autosomal recessive pattern. An X-linked inheritance has also been reported. Many EV patients have a cellular immunity defect. HIV-associated lesions have been found to contain HPV-5, HPV-8, and HPV-20.

Objective:

We describe two HIV-positive Hispanic maternal half brothers who presented with asymptomatic polyangular papules and plaques on the face, trunk, and extremities and which first appeared 4–5 years prior. The histopathology is consistent with EV. HPV-8 was detected by in situ hybridization. The patients were treated with topical imiquimod for two months without improvement.

Conclusion:

To our knowledge, this is the first reported case of epidermodysplasia verruciformis in HIV-positive pediatric patients.
The Frequent Use of Oral Retinoids in Combination with other Treatments for Psoriasis: A Retrospective Analysis
Authors: Hu Judy , Balkrishnan Rajesh , Camacho Fabian , Lang Wei , Pearce Daniel J. , Fleischer Alan B. , Feldman Steven R.
Published: July 2017

Background:

Combination treatment in psoriasis may be common, logical, and appropriate, even if not well tested or well documented by clinical trials. While oral retinoids such as acitretin can be used as monotherapy, efficacy can be further augmented by combination use with other agents. Similarly, because of its safety profile, acitretin can be added in low doses to help patients who have not achieved adequate control with other psoriasis treatments.

Objective:

The purpose of this study was to assess how oral retinoids are used in combination with other drugs to treat psoriasis.

Methods:

We assessed the use of acitretin and other oral retinoids for the treatment of psoriasis using two sources of information: nationally representative survey data from the National Ambulatory Medical Care Survey (NAMCS) and local data obtained by chart review of 518 patients seen in a university dermatology clinic.

Results:

In the NAMCS, oral retinoids were prescribed with other psoriasis medications at 71% of visits. In the chart review, combination use was even more frequent (96% of subjects were on combination treatment) and included combinations of acitretin with topicals, phototherapy, and other systemic treatments. Adverse events were reported in 53% of patients treated with acitretin, although none were severe.

Conclusion:

Use of acitretin in combination with many other psoriasis treatments is a common practice. Mucocutaneous side effects of oral retinoids are common but with appropriate dosing are generally mild.
Introduction
Authors: Sauder Daniel N.
Published: July 2017

Psoriasis is an immune-mediated skin disease in which T cells initiate and maintain the pathogenic process.1 T cells become activated, migrate into the skin, and induce the keratinocyte proliferation associated with the psoriatic phenotype. The activated T cells that infiltrate the skin express the memory phenotype (CD45RO+).2,3 Both CD4+ and CD8+ memory T-cell subtypes are believed to play a role in the pathogenesis of psoriasis. The effectiveness of many traditional therapies for psoriasis (e.g., cyclosporine, methotrexate, psoralen/ultraviolet A light) can be attributed, at least in part, to the potent immunosuppressive effects of these treatments.4,5 Unfortunately, a lack of selective targeting of the immune system by these therapies may result in treatment-limiting side effects.
Esophageal Stricture in a Patient with Epidermolysis Bullosa Acquisita: Endoscopic and Medical Management
Authors: Lazas Donald J. , James William D. , Yancey Kim B. , Kikendall James W. , Wong Roy K. H.
Published: July 2017

Background:

This 40-year-old man with extensive and severe epidermolysis bullosa acquisita (EBA) developed an esophageal stricture that caused dysphagia and limited his nutritional intake.

Objective:

The purpose of the evaluation and management was to relieve the symptomatic obstruction so that he could better swallow food and medications.

Methods:

Endoscopic visualization of the stricture allowed for balloon dilation to be effected. The radial forces applied probably allowed for a less traumatic intervention than the linear shearing forces of bougienage.

Results:

The stricture widened and immediately provided less dysphagia and better tolerance in ingesting food. Medical treatment with sucralfate, known to bind to and protect ulcer bases, also improved his symptoms.

Conclusions:

Esophageal strictures are relatively uncommon in patients with EBA; however, when faced with a stricture in this or other scarring bullous diseases that affect the esophagus, endoscopic balloon dilation combined with postprocedure sucralfate offers improvement with advantages over older methods of intervention.
Nasal Reconstruction with an Elongated Right Paramedian Flap after Maxillectomy for Basal Cell Carcinoma
Authors: Camacho Francisco M. , Moreno Jose C. , Rodriguez-Adrados Felipe
Published: July 2017

Background:

An extensive basal cell carcinoma that reached the maxillary sinus was removed. In the first reconstructive stage, we closed the primary defect on the sinus with a rotation-transposition flap. The distal portion of the flap necrosed, producing a defect in the nasolabial fold that left the sinus open and caused upward retraction of the upper lip.

Objective:

The defect of the nasolabial fold had to be corrected and the sinus closed; in a later stage, the retractile scar that appeared on the upper lip also needed correction.

Methods:

We used a delayed, elongated, right paramedian flap to correct the defect on the nasolabial fold and to close the sinus. We then corrected the retractile scar on the upper lip with a V-Y advancement flap.

Results:

The defect was closed without complications and the V-Y flap worked in returning the upper lip to its anatomic position.

Conclusion:

The midforehead flap is best for the reconstruction of the tip and the alar areas of the nose, including the near nasolabial fold. The V-Y advancement flap is an easy flap that allows one to correct retractions around the facial orifices. In dermatologie surgery, the final results must be as esthetic as possible.
Contact Dermatitis to Polysporin® Masquerading as a Delayed-Type Hypersensitivity Response to Dye Pigment
Authors: Bellman Betty , Brandt Fredric S.
Published: July 2017

Background:

A 15-year-old Hispanic adolescent with multiple amateur India ink tattoos developed a recurrent, eczematous pruritic eruption several weeks after each treatment with the Q-switched ruby laser.

Objective:

To determine if the patient was having an allergic reaction to tattoo dye pigment or an allergic contact dermatitis.

Methods:

Open- and closed-patch testing was performed to Polysporin® ointment, which revealed a 2+ vesicular reaction.

Conclusion:

Delayed-type hypersensitivity responses to contact allergens can very closely mimic the less common allergic reactions to dye pigment from tattoos. Open- and closed-patch testing to topical medications should be performed on any patient suspected of having an allergic reaction to tattoo dye pigment.
Primary Systemic Amyloidosis
Authors: Levesque Marte-Hélène , Doré Normand , Marion Alain , Cadotte Marcel
Published: July 2017

Background:

Primary systemic amyloidosis is a rare disease with multiorgan involvement including the skin. Because of the nonspecific and variable presenting symptoms and signs, this condition usually follows a long course before the correct diagnosis is established. Fortunately, skin manifestations contribute greatly in revealing the disease and determining the amyloidosis type.

Objective:

This article reports a case of primary systemic amyloidosis mimicking nodular primary localized cutaneous amyloidosis of the legs. We describe our systemic findings and the investigation procedure to classify and characterize the amyloidosis type.

Methods and Results:

After histologic studies revealed amyloid substance in the skin nodules of our 82-year-old patient, she was hospitalized for an appropriate systemic evaluation of this condition and associated medical problems. The investigation included biochemical, immunologic, radiologic, pathologic, and histochemical methods.

Conclusion:

This case of primary systemic amyloidosis, simulating a localized cutaneous form with nodular lesions, demonstrates the importance of the distinction between both entities. In fact, the management and prognosis will vary significantly.
Effect of Nitroglycerin Ointment on Psoriatic Plaques
Authors: Morhenn Vera B.
Published: July 2017

Background:

Nitric oxide is thought to play a major role in a number of inflammatory diseases. Psoriasis is a common inflammatory disease of the skin.

Objective:

To determine the effect of nitric oxide on psoriasis, nitroglycerin that is converted into nitric oxide in human skin was applied to psoriatic plaques.

Methods:

Nine individuals with chronic plaque-type psoriasis were treated with nitroglycerin ointment for 6 weeks.

Results:

The plaque of one individual improved with the application of nitroglycerin. By contrast, one individual's nitroglycerin-treated plaque improved dramatically about 6 weeks after cessation of treatment. On the other hand, the plaques of five individuals worsened with nitroglycerin treatment. Moreover, in one individual, the nitroglycerin-treated plaque increased in size, whereas the placebo-treated plaque improved slightly.

Conclusion:

Nitroglycerin ointment and, by extension, nitric oxide, may affect both the initiation and resolution of psoriasis.
Development of Diagnostic Criteria for Common Warts (Verrucae Vulgaris)
Authors: Young Richard , Kilkenny Monique , Jolley Damien , Marks Robin
Published: July 2017

Background:

Warts are common skin conditions. In most instances, their diagnosis by medical practitioners is a subjective or intuitive decision.

Objective:

To develop and assess a minimum set of diagnostic criteria for diagnosis of common warts.

Methods:

Patients with warts and other lesions were recruited. The lesions were diagnosed by the key dermatologist, whose diagnosis was used as the gold standard. They were then examined by two independent medical practitioners, who used a checklist of diagnostic criteria to determine whether the lesions had any or all of the characteristics. A minimum set of diagnostic criteria for common warts was then derived using logistic regression.

Results:

The diagnostic criteria were: site of wart (elbow, finger, or knee), flesh colour, hyperkeratosis, and discrete margin.

Conclusion:

Further studies are needed to compare these diagnostic criteria with the medical practitioners' intuitive diagnosis.
When Subjects are Not Randomly Assigned: The Cohort Approach
Authors: Karagas Margaret R.
Published: July 2017

Background:

Cohort studies are often used to answer clinical and etiologic questions.

Objective:

This article is to provide an overview of the basic concepts of cohort studies that are pertinent to the evaluation of the published literature.

Methods:

Fundamental principles, methods of assessing exposure and outcome status, choice of a comparison group, and statistical methods used in cohort studies are reviewed. Studies focusing on skin neoplasms are used as examples.

Results:

Methods used in cohort studies are similar to those used in clinical trials. One of the distinguishing features is that the exposure (e.g., treatment) is observed rather than assigned by the study investigators. Therefore, an effort must be made to ensure comparability between exposed and unexposed groups.

Conclusion:

Cohort studies have provided valuable clinical and etiologic information, but the strengths and limitations of this approach need to be recognized when evaluating the literature.
Distinctive Dermatoscopic Features of Acral Lentiginous Melanoma in Situ from Plantar Melanocytic Nevi and Their Histopathologic Correlation
Authors: Kawabata Yasuhiro , Tamaki Kunihiko
Published: July 2017

Background:

An acral lentiginous melanoma in situ on the sole is often difficult to differentiate with the naked eye from an acquired plantar melanocytic nevus. Recent technical advances in epiluminescence microscopy have contributed to the differentiation of these two pigmented skin lesions.

Objective:

In this study, the correlation between dermatoscopic and histopathologic findings of acral lentiginous melanoma in situ on the sole are compared to those of acquired plantar melanocytic nevi.

Methods:

Three acral lentiginous melanomas in situ on the sole, and two cases of acral lentiginous melanoma were compared with 50 acquired plantar melanocytic nevi by means of dermatoscopy and histopathology.

Results:

The dermatoscopic surface profiles of acquired melanocytic nevi were composed of linear pigmentation accentuated mainly on the sulcus superficialis. Histologically, some areas of the sulcus superficialis corresponded to rete ridges of the epidermis, and nests of nevus cells were also often located there. In contrast, the acral lentiginous melanomas in situ showed diffuse, irregularly shaped pigmentation distributed in a disorderly fashion over the entire surface. Histologically, isolated areas of proliferation and small nest formations of atypical melanocytes were irregularly distributed in the epidermis.

Conclusion:

A distinctive dermatoscopic feature of acral lentiginous melanoma in situ is diffuse and irregular pigmentation over the entire surface of the lesion. This feature is helpful for differentiating acral lentiginous melanoma in situ from acquired plantar melanocytic nevi.
Direct Immunofluorescence Diagnosis of Pemphigus without Biopsy
Authors: Feliciani Claudio , Pour Saman Mohammad , Toto Paola , Coscione Giulia , Amerio Paolo , Amerio Pierluigi
Published: July 2017

Background:

Direct immunofluorescence (DIF) is a necessary examination tool for the diagnosis of pemphigus. The suction-blister-method splits the skin at the lamina lucida and it is possible with a scalpel to separate the entire epidermis from the dermis.

Objective:

The study was to determine whether DIF is reliable on epidermal sheets separated using a suction apparatus.

Methods:

Thirteen patients were selected for this study: (nine with pemphigus vulgaris (PV), one with paraneoplastic pemphigus (PP), and three with pemphigus erythematosus (PE). Frozen epidermal sheets, separated from the dermis with a scalpel, were used as a substrate. Diagnosis with routine fluorescein isothiocyanate (FITC) antibodies was made.

Results:

In all patients a pericellular deposition of IgG was evident and in eight of these patients a pericellular deposition of C3 was present. In two cases of PE and one of PP, the C3 deposits were also present in the lower part of basal keratinocytes.

Conclusion:

This diagnostic method without skin biopsy is easy to perform and, together with the histology and clinical aspects, could be a useful tool in the diagnosis of pemphigus. We recommend this method when the patient is allergic to local anaesthetics, the patient easily produces hypertrophic scars, or in follow-up of already biopsied patients.
Undergraduate Dermatology Education in Canada: A Survey
Authors: Murray Scott J. , Raymond Giles P.
Published: July 2017

Background:

Two reviews done in the 1980's showed that many Canadian medical schools scheduled relatively little time for dermatological teaching. Many students did not have a real clinical exposure to dermatology.

Objective:

The purpose of this study was to obtain new data to reevaluate the undergraduate training in dermatology in Canada.

Methods:

A survey was sent to the coordinators of undergraduate dermatology of all 16 Canadian medical schools.

Results:

The survey of medical schools demonstrates the current status of dermatology undergraduate teaching across Canada. Although many improvements have been made in the way dermatology is taught to medical students, many of the problems noticed in the 1980s remain unresolved.

Conclusion:

Because dermatological care in Canada is often rendered by nondermatologists, the dermatologists should emphasize the importance of undergraduate training in their specialty.
Patching Together the Genetics of Gorlin Syndrome
Authors: Bale Sherri J. , Falk Roni T. , Rogers Geraldine R.
Published: July 2017

Background:

Gorlin syndrome is an autosomal dominant disorder characterized by developmental defects and susceptibility to cancer, especially to basal cell carcinomas. The genetic basis of this disorder has recently been elucidated.

Methods:

In this article previous studies are reviewed in which loss of heterozygosity analysis of tumours and normal tissue pointed to a region on chromosome 9 as being involved in Gorlin syndrome. In this light, Knudson's two-hit model is discussed. The identification of the involvement of the patched gene in Gorlin syndrome is reviewed. New data on genotype-phenotype correlations in the syndrome are presented.

Results:

Loss-of-heterozygosity studies, together with standard family studies using linkage analysis, have proved useful in identifying the location of a gene with complex phenotypic expression.

Conclusion:

The application of the two-hit model, as utilized in loss-of-heterozygosity studies, has been very useful in elucidating the genetic basis of Gorlin syndrome. There may be a correlation between certain aspects of the mutations in patched and the clinical presentation of the disorder in families.
Diagnosing Basal Cell Carcinoma by Dermatoscopy
Authors: Carroll David M. , Billingsley Elizabeth M. , Helm Klaus F.
Published: July 2017

Background:

Dermatoscopy (DS) has been used primarily to evaluate pigmented skin lesions. Little information is available on DS findings of basal cell carcinoma (BCC). Dermatoscopy is a noninvasive technique that allows visualization of cutaneous features from the skin surface to the papillary dermis. Basal cell carcinoma, the most common cutaneous malignancy, is traditionally diagnosed clinically and confirmed with biopsy.

Objective:

To determine the dermatoscopic features of non-pigmented basal cell carcinomas.

Methods:

The dermatoscopic findings of 27 lesions that clinically were suspicious for BCC were analyzed.

Results:

Of these 27 clinically suspect lesions, the biopsies revealed BCC in 20 specimens and squamous cell carcinoma (SCC) in two specimens. Twenty of these 22 specimens had dermatoscopic findings of BCC: diffusely distributed, branching blood vessels, asymmetric, and narrow blood vessels distributed deeper in the dermis, or a milky-red corona with superficial wide blood vessels. One nodular BCC in our study showed no distinct findings.

Conclusions:

Many BCCs have characteristic DS findings; however, dermatoscopic examination of some tumours will not demonstrate any known characteristic findings. As such, the DS criteria we propose for BCC are best utilized as an adjunctive study of clinical impressions. Biopsy remains the definitive diagnostic tool.
Lichen Planus Localized to the Nails
Authors: Albert Michael R. , Li Vincent W. , Buhac Jean , Dover Jeffrey S. , González Ernesto
Published: July 2017

Background:

Lichen planus may rarely be localized to the nails.

Objective:

A case of ungual lichen planus is reported that was misdiagnosed as onychomycosis.

Methods:

A 52-year-old woman had progressive nail dystrophy for 13 months that was unresponsive to oral terbinafine. A nail biopsy was performed.

Results:

Histopathologic findings were consistent with lichen planus.

Conclusion:

Onychomycosis may be confused clinically with other causes of nail dystrophy. It is important to confirm the diagnosis of onychomycosis with appropriate laboratory or histologic analysis.
Plaque-Type Multinucleate Cell Angiohistiocytoma
Authors: Issa Ahmed Al , Lui Harvey , Shapiro Jerry , Trotter Martin J.
Published: July 2017

Background:

Multinucleate cell angiohistiocytoma (MCAH) is a rare cutaneous disorder that usually presents as papules or nodules.

Objective:

This article reports a case of MCAH that appeared clinically as a large cutaneous plaque.

Methods and Results:

A 74-year-old woman presented with a large painless, dusky red, indurated plaque measuring 12 × 6 cm on the trunk that was found on histopathologic examination to be a MCAH. Based on a literature review, this is the first reported case of MCAH presenting as a plaque rather than a papule or nodule.

Conclusion:

Multinucleate cell angiohistiocytoma may manifest clinically as a solitary cutaneous plaque.
Treatment of Refractory Solar Urticaria with Plasma Exchange
Authors: Bissonnette Robert , Buskard Noel , McLean David I. , Lui Harvey
Published: July 2017

Background:

Solar urticaria is a photodermatosis that can be very disabling for patients who are highly sensitive to light and can also be very resistant to therapy.

Objective:

To correlate the results of serial phototesting in a patient with severe and refractory solar urticaria before and after treatment with plasma exchange.

Methods:

Plasma exchange was performed five times over a period of 10 days. Phototesting to ultraviolet A (UVA) irradiation and visible light was performed with fluorescent ultraviolet tubes and an incandescent lamp.

Results:

The urticaria that developed after very low light doses during baseline phototesting could not be provoked following plasma exchange. The patient is now almost symptom-free, with only occasional and transient hives more than 21 months after her last plasma exchange.

Conclusions:

Plasma exchange is a therapeutic modality to consider in highly light-sensitive patients when other treatments have failed.
Understanding Research about Quality of Life and other Health Outcomes
Authors: Chren Mary-Margaret
Published: July 2017

Background:

Papers reporting studies of health outcomes, particularly patients' perceptions, are becoming more common. Understanding the characteristics of tools used to measure these health outcomes is important for interpreting these studies accurately and applying them to clinical care.

Objective:

The purpose of this article is to describe important features of the measurement of patient-perceived health outcomes, and to illustrate how a consideration of these features can help in applying study results to individual patients.

Conclusion:

Understanding the principles of measurement is particularly important for interpreting studies of dermatological care, in which patients' perceptions are a crucial outcome.
A Digital Archive in the Circus: Between the Archive and the Repertoire
Authors: Carlin David
Published: July 2017

This article discusses the phenomenon of the digital archive, in the context of performance practice and studies, as a potential liminal performance space blurring the boundaries between archive and repertoire (Taylor 2003). It takes the Circus Oz Living Archive as a case study to examine the opportunities and challenges facing cultural organisations wanting to take charge of the multimodal telling of their own histories, as digital technologies impact on practices of remembrance, archiving and performance in the cultural sector. The governing metaphor of the archive shifts from the spatial – a site of recorded memory – to the temporal – an unfolding event of memory. This presents a great challenge for a performing arts company like Circus Oz, which already faces the task of delivering its live show to audiences around the world. How does such a company think through the many issues arising in relation to adding this new digital performance to its repertoire?
Queering Sexting and Sexualisation
Authors: Albury Kath , Byron Paul
Published: July 2017

Recent Australian research on ‘sexting’ (the production and exchange of naked and semi-naked digital pictures) has observed that formal legal and educational discourses have failed to fully account for young people's understandings and experiences. While there is a proliferation of scholarly and popular texts focusing on the risks that sexting might pose to young (heterosexual) women, there is a relative absence of academic, educational or popular discourse acknowledging same sex-attracted young people's participation in cultures of creating and sharing pictures via dating and hook-up apps. This article draws on focus-group interviews with young people in Sydney (aged 18–26) to present alternative accounts of sexting, and reflect on same sex-attracted men and women's strategies for negotiating safety and risk within online and offline sexual cultures.
Television Serials — A Diffusion Study
Authors: Case Dominic
Published: July 2017

95 subjects were asked how they first became aware of four TV serials, and when. Results indicated that mass media channels of communication were more effective in producing awareness of the programs, but regular viewers and early knowers were more affected by interpersonal channels. ABC serials had a higher percentage of regular viewers than the commercial serials.
The Australian Broadcasting Tribunal and Media Monopolies
Authors: Watterson Ray
Published: July 2017

In October, 1478 the NSW Branch of the Australian Labor Party announced that it had entered into an agreement to sell its interest in Newcastle radio station 2HD to that region's sole commercial television station, NBN-3. The acquisition by NBN-3 of 2HD would have created the highest degree of concentration of electronic media ownership within the one city in the history of Australian broadcasting.

That announcement generated one of the most politically intriguing and legally important sequence of events in the history of Australian broadcasting regulation. The decision to sell 2HD generated bitter division within the Labor movement and has thus far lead to two Supreme Court actions, two separate hearings by the Australian Broadcasting Tribunal and promises to lead to the High Court. At this moment the most important event from the point of view of broadcasting law and policy is the decision of the Australian Broadcasting Tribunal which finally emerged on 19th July, 1979.

The Australian Broadcasting Tribunal denied its consent, necessary for the transfer of the station's licence, when after the second of its hearings into the matter it concluded that the result of the sale would have been to place the control of the available commercial electronic media outlets in the Newcastle region into too few hands. In the Tribunal's view such a situation “would have been contrary to the interests of the Newcastle public as they relate to broadcasting services available to them”.
International Imagery: A Study of British Children's Explanations of other Countries
Authors: Nightingale Virginia
Published: July 2017

In a study of television's role in the definition of the explanations 120 British children gave about other countries, television's influence was found to be limited by the socio-cultural context of Britain's strategic relations with other countries, and the children's social class location. Television was most important as a source of information about the super-powers (the USA and USSR), with both entertainment and news/documentary formats interacting to perpetuate imagery and emotional reactions.
Press Definitions of Reality: Melbourne's Victoria Market Shootings
Authors: White Peter B , Rosh Naomi
Published: July 2017

In 1963 and 1964 four people associated with Melbourne's wholesale fruit and vegetable market were the victims of shotgun attacks. Because ail the victims were of Italian origin, newspaper reports depicted the crimes as the work of a Mafia organization. This analysis of the press reports, based on the theoretical work of Alfred Schutz, shows how the crimes and the police investigation were described in Melbourne's daily newspapers. The reports in the different newspapers are compared, and the differences are explained by referring to the journalists' expectations about the interests of their readers.
Who are Those Journalists? (And Why are They Saying Such Critical Things?)
Authors: Rothman Stanley , Lichter S Robert
Published: July 2017

The American Media

The media have become one of the most powerful influences on our information hungry society. Their new prominence has been propelled by the rise of print and television outlets with national impact. This select group includes the three television networks and the Public Broadcasting System (PBS), three national news magazines (Time, Newsweek, U.S. News and World Report) and the major American newspapers — the New York Times, the Washington Post, and the Wall Street Journal.
A Comprehensive Approach to Strategic Management
Authors: Richardson Bill
Published: July 2017

This paper is based on the assumption that many texts and programmes of study on strategic management either ignore or address only vaguely the issue of defining strategic management, or promulgate the author/designer's unhelpfully narrow viewpoint. It provides a multi-perspective view of strategic management which more nearly reflects its practice, and is more helpful to the development of strategic management skills. It discusses the confusion about what `strategic management' means and examinesit as a concept which embraces the approaches of a range of theoretically espoused leader-types. This view is then contrasted with `this is the only way' and `specific leader style to fit specific strategic context' prescriptions. The paper concludes by discussing implications raised for practitioner and student strategists and their skills development supporters.
Tourism Economics: Life after Death?
Authors: Tribe John
Published: July 2017

Paul Omerod's recent book, The Death of Economics, provides the background to this paper. As Omerod's book laments the state of mainstream economics it seems an appropriate time to subject economics for tourism degrees to similar critical scrutiny. There has been a rapid growth in institutions offering degrees in tourism, from none in 1985 to 40 and rising by 1995, and economics has generally been part of the package on offer to students. This paper starts by outlining three serious challenges to economics both as a discipline and as educational knowledge for tourism students. It then examines how the educational package of economics is framed, and from this concludes that economics courses may arise more from accident (or inertia) than design, or that the design may not be appropriate for current needs. It therefore suggests that there is considerable scope for the re-framing of introductory economics for tourism students. In the light of the criticisms of economics expressed in the first section, a model curriculum for tourism economics is proposed, and ways in which such a model might be promoted and developed are explored.
Modelling Quarterly Tourist Flows to Australia Using Cointegration Analysis
Authors: Kulendran N.
Published: July 2017

The purpose of this paper is to use cointegration analysis to estimate the long-run relationship between quarterly tourist flows to Australia from the USA, Japan, to UK and New Zealand and the factors such as income, price and airfare that influence arrivals. To this end, the demand function approach to tourism flow modelling is employed. The new econometric modelling approach of cointegration analysis adopted in this paper has not been used in previous studies of tourism demand modelling. This method is capable of overcoming the problem of ‘spurious regression’ associated with traditional econometric modelling approach for estimating the tourism demand function. For the countries of origin, the estimated long-run income elasticity is greater than one, and considerably higher for Japan. UK tourists are more responsive to changes in airfares than to changes in income. The estimated long-run elasticity with respect to the relative price variable for the UK and Japan is close to unity, and for the USA and New Zealand it is greater than one.
Competition and Contestability in the UK Package Tour Industry: Some Econometric Observations
Authors: Davies Brian , Downward Paul
Published: July 2017

This paper explores competition and contestability in the UK package tour industry. Using econometric analysis of a panel-data set evidence is presented that rules out the market power/efficiency hypothesis. In keeping with Evans and Stabler (1995), there is evidence that the industry is segmented according to the size of the firms. In contrast with Gratton and Richards (1997), the results suggest that it is difficult to support the contestability hypothesis in the industry overall. Future research needs to offer less generalized conclusions in characterizing the industry.
Liam and Noel in Balloch: An Economic Impact Assessment
Authors: Senior Graham , Danson Mike
Published: July 2017

This paper estimates the economic benefits that can accrue to a small local economy as the result of staging a major cultural event – a two-day rock festival starring the band Oasis. The paper shows that one-off events do bring economic benefits to the local area, but that they are short-lived, and enjoyed by a few rather than the community as a whole. An events strategy needs to be developed to enable the local business community to plan in advance to take full advantage of the commercial opportunities that such events bring.
The association of mobility disability and weight status with risk of disability pension: A prospective cohort study
Authors: Norrbäck Mattias , de Munter Jeroen , Tynelius Per , Ahlström Gerd , Rasmussen Finn
Published: July 2017

Background/Aims: Mobility disability (MD) and obesity are conditions which have been associated with weaker labour market attachment. This study investigates whether the combined burden of MD and obesity increase the risk of disability pension compared with having only one of these conditions (the reference group). Methods: A nationwide cohort study, based on national surveys made between 1996 and 2011, was conducted including 50,015 individuals aged 19–64 years who were followed-up in a large database in terms of attainment of disability pension until 31 December 2012 (at the latest). Proportional hazards regression models were used to analyse the risk of all-cause and diagnosis-specific disability pension with six exposure groups, established by mobility and weight status (BMI) obtained through self-reports. Results: A total of 2296 participants had received disability pension after a mean follow-up period of 7.2 years (SD 4.6). People with MD, regardless of weight, had 4–8 times higher risk of disability pension (for any reason) compared with the reference group (individuals with normal weight and no MD). Conclusions: No evidence of a double burden of MD and obesity with disability pension was observed in this study. MD seemed to contribute more to the risk of disability pension than weight status. In a long-term perspective, society and also people at risk of these disabling conditions would benefit from reallocation of resources from disability pensions to health-promoting and preventive policies, not least targeting MD.
Psychological distress among Norwegian adolescents: Changes between 2001 and 2009 and associations with leisure time physical activity and screen-based sedentary behaviour
Authors: Kleppang Annette Løvheim , Thurston Miranda , Hartz Ingeborg , Hagquist Curt
Published: July 2017

Aims: The aim of this work was to examine psychological distress among Norwegian adolescents in relation to changes over time and the associations with leisure time physical activity and screen-based sedentary behaviour. Methods: This cross-sectional study was based on data retrieved from the Norwegian Youth Health Surveys in 2001 and 2009 in Hedmark County. Adolescents aged 15–16 years old completed a questionnaire regarding physical activity, sedentary behaviour, psychological distress and other health and lifestyle variables. The self-report Hopkins Symptom Checklist-10 was used to assess psychological distress. Multinomial logistic regression was used to analyse the associations between psychological distress, physical activity and sedentary behaviour. Results: Self-reported psychological distress increased significantly from 2001 to 2009 (from 19.4 to 28.2%), with the proportion of girls reporting psychological distress being twice as large as the proportion of boys. The proportion of adolescents who were physically active for ⩾11 hours per week increased significantly over the same period (from 6.0 to 10.4%). Sedentary behaviour ⩾6 hours per school day increased significantly among both sexes between 2001 and 2009. Physical activity (⩾11 hours) and sedentary behaviour (⩾6 hours) were both significantly associated with psychological distress. Conclusions: The association between physical activity, sedentary behaviour and psychological distress was weak; only high amounts of physical activity and high amounts of screen-based sedentary behaviour were associated with psychological distress. Longitudinal studies are needed to provide further insights into these associations and to understand the extent to which these variables might be causally related.