bluuebunny/crossref_metadata_2025 huggingface dataset:
When Studies are in Error: Basic Statistical Vocabulary Needed to Understand Clinical Studies
Authors: Weinstock Martin A.
Published: July 2017

Background:

Accurate understanding of certain basic statistical terms and principles is key to critical appraisal of published literature.

Objective:

This review describes type I error, type II error, null hypothesis, p value, statistical significance, a, two-tailed and one-tailed tests, effect size, alternate hypothesis, statistical power, β, publication bias, confidence interval, standard error, and standard deviation, while including examples from reports of dermatologic studies.

Conclusion:

The application of the results of published studies to individual patients should be informed by an understanding of certain basic statistical concepts.
Elastophagocytosis: A Clue to the Diagnosis of GM-CSF-Induced Dermatosis
Authors: Zalka Alicia D. , Ryan Anna Sarno , Worobec Sophie M. , Scott Glynis A.
Published: July 2017

Background:

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a cytokine used to stimulate the production of leukocytes and monocytes in neutropenic patients. Cutaneous reactions to GM-CSF are relatively common. However, documentation of the histologic features of GM-CSF-induced dermatoses has only been reported in nine patients. We previously reported three patients with GM-CSF dermatoses, all of whom demonstrated enlarged macrophages in the dermis. Biopsies from two of the patients showed intracytoplasmic elastin fragments in dermal macrophages consistent with GM-CSF's documented ability to increase phagocytic activity of macrophages in vitro.

Objective:

The objective of the present report is to present an additional case of GM-CSF-induced dermatoses and to document the apparent ability of this cytokine to induce phagocytosis of elastin fragments by macrophages.

Methods and Results:

The patient received GM-CSF to stimulate bone marrow recovery after a bone marrow transplant. He developed a diffuse macular papular rash that on biopsy revealed enlarged dermal macrophages with prominent intracytoplasmic elastin fragments.

Conclusions:

Elastophagocytosis by activated macrophages is a common finding in GM-CSF-induced dermatoses and is a relatively specific clue to the diagnosis of this disorder.
Foreign Body Granulomatous Reaction Presenting as Systemic Sarcoidosis: A Case Report with Energy-Dispersive Spectroscopy Analysis
Authors: Singer Michael , Srolovitz Herb , Bullick Robin , Dufresne André
Published: July 2017

Background:

Sarcoidosis is an immune-mediated idiopathic disorder and is generally thought to be a diagnosis of exclusion. Although researchers have looked at viruses, mycobacteria, and certain chemicals as possible triggers, the initiating antigen remains unidentified.

Observations:

A 41-year-old black male metal-worker previously diagnosed with systemic sarcoidosis presented with a 6-month history of recurrent, sometimes tender, skin nodules on the lower legs. Chest film, gallium scan, and angiotensin-converting enzyme (ACE) level results supported a diagnosis of systemic sarcoidosis. A biopsy of a lower extremity skin nodule showed confluent non-necrotizing granulomas with irregular birefringent particles in giant cells in a fibrous tissue background suggestive of a silica nodule. Review of a previous bronchial biopsy showed similar foreign body granulomas. Energy-dispersive spectroscopy (EDS) analysis of skin and lung tissue revealed mainly silica, clay (kaolinite), chromium, and aluminum particles that were consistent with the patient's occupational exposure.

Conclusions:

ACE level and gallium scan may not be specific for sarcoidosis. In certain occupational settings, EDS analysis should be considered before a diagnosis of sarcoidosis is made. This case may provide insight into the etiology of certain presentations labelled as sarcoidosis.
Trichothiodystrophy: Current Concepts
Authors: Price Vera H.
Published: July 2017

Background:

Trichothiodystrophy (TTD) is a rare, autosomal recessive disorder in which the hair identifies a group of genetic disorders with deficient high-sulfur matrix proteins, and a defect in excision repair of ultraviolet damage in fibroblasts of most patients. TTD patients may be grouped as follows: (1) the major group with defects in the excision repair cross-complementing gene ERCC2, the gene for xeroderma pigmentosum group D (XP-D); (2) those with defects in ERCC3, the gene for XP-B; and (3) those with a repair defect distinct from those in XP-D and XP-B. In contrast to XP patients, TTD patients have no increased frequency of skin cancers.

Objective:

The article explains the relationship of TTD and XP and helps clarify why TTD patients with defects in the same gene(s) as those with XP do not have increased skin cancers.

Methods:

Methods include biochemical studies, mutational analysis, and genomic sequence analysis of cell lines from skin biopsies of TTD and XP patients.

Results:

The ERCC2 gene is a component of the TFIIH complex which controls two distinct DNA-metabolizing processes, transcription initiation and nucleotide excision repair.

Conclusion:

In TTD, the major defect is in transcription initiation, whereas in XP-D, DNA repair is primarily altered.
Bone Complications of Corticosteroids
Authors: Lester Robert S.
Published: July 2017

Background:

Systemic corticosteroids, a mainstay of treatment for severe dermatosis, are associated with systemic complications. Adverse effects of corticosteroids to bone represent a significant adverse effect that, is poorly understood and poorly managed.

Objectives:

The purpose of this article is to educate dermatologists to the current understanding of the pathogenesis, diagnosis, and treatment options available for bone complications of corticosteroids.

Results:

Virtually all patients chronically exposed to high-dose corticosteroid therapy lose bone mass and are at risk for osteoporotic fractures. In addition, osteonecrosis is an unpredictable complication of corticosteroid therapy that may occur with even low-dose corticosteroids.

Conclusion:

Optimal risk management of corticosteroid therapy includes understanding the risk factors associated with bone complications and improving communication with patients.
Immunosuppressive and Cytotoxic Drugs in Dermatology: A Practical Overview and Personal Perspective
Authors: Callen Jeffrey P.
Published: July 2017

Background:

Cytotoxic/immunosuppressive drugs are regularly used to treat proliferative diseases of the skin and immunologically mediated inflammatory disorders.

Objective:

The rational use of cytotoxic/immunosuppressive drugs, which depends on the proper selection of both the patient and the drug, is discussed.

Conclusion:

Methotrexate, azathioprine, cyclophosphamide, chlorambucil, cyclosporine, and other related drugs have potential benefits in the treatment of severe recalcitrant cutaneous disease. Patients may survive otherwise fatal disorders, or may improve their life-style and become productive again. However, the beneficial effect of these agents is achieved when the blood level is at or near toxic level. Thus, the prescribing physician should have a familiarity with the potential toxicities and a knowledge of proper monitoring techniques.
Differential Induction of IL-12 p40 and IL-10 mRNA in Human Langerhans' Cells and Keratinocytes by in Vivo Occlusion, Vehicle, and All-TRANS Retinoic Acid
Authors: Chen Guofen , Kang Kefei , Kang Sewon , Rook Alain H. , Kubin Marek , Voorhees John J. , Cooper Kevin D.
Published: July 2017

Background:

Hydration and pharmacologic manipulation of the skin may have immunomodulatory effects. For instance, retinoic acid (RA) in vivo upregulates antigen-presenting cell (APC) activity of Langerhans' cells (LC).

Objective:

Our study was to determine whether RA increases LC APC activity via alteration of the potent immunoregulatory and reciprocally acting cytokines, IL-12 and IL-10.

Methods:

0.1% RA and vehicle solvent only (V) as a control were applied under occlusion on the skin of normal volunteers. Freshly selected CD1a+ LC and keratinocytes from keratome were subject to semiquantitative determination of IL-12 p40 and IL-10 mRNA levels. IL-12 p40 protein was measured by radioimmunoassay.

Results:

Occlusion alone and open vehicle alone did not induce LC immunoregulatory cytokines; LCs demonstrated significant induction of IL-12 p40 mRNA, when the vehicle was occluded for 48 hours and, to a lesser extent, IL-10 as well. IL-12 p40 mRNA could be further induced by RA-LC at the 20-hour time point; however, IL-10 mRNA was induced at the 48-hour time point. Neither occlusion nor RA significantly induced IL-12 p40 or IL-10 mRNA in CD1a keratinocytes at any time points.

Conclusion:

A tight reciprocal regulation of IL-10 and IL-12 is present in LCs and is consistent with the initial, but self-limited, inflammatory effect of occlusion and topical retinoids.
Anatomic Distribution of Cutaneous Melanomas and Painful Sunburns in Adults
Authors: Wasti Qasim H. , Kopf Alfred W. , Marghoob Ashfaq A. , Stefanato Catherine M. , Romero Judith B. , Rao Babar K. , Bart Robert S.
Published: July 2017

Background:

Data show that intermittent painful sunburns are an important causative factor for cutaneous malignant melanoma.

Objective:

This study was undertaken to determine whether the differences in the anatomic distribution of melanomas in men, compared to women, could be accounted for by the distribution of sunburns and whether the high incidence of melanomas on the lower extremities of women is associated with the distribution of sunburns.

Methods:

One hundred and fifty nonmelanoma patients, men and women aged 20 to 60 years, recalled having painful sunburns within the previous 6 months. The locations of the sunburns were indicated on body surface diagrams. The locations of 1168 melanomas as recorded in the NYU-Melanoma Cooperative Group data base were plotted on anatomic diagrams. The anatomic distribution of melanomas and of sunburns for men and women were compared.

Results:

There was no statistically significant difference in the distribution of sunburns on any anatomic location in men as compared to women. However, there was a disproportionately high number of melanomas on the backs of men and on the legs of women. In both men and women, there was a significant difference between the anatomic distribution of painful sunburns and melanomas.

Conclusion:

Since the anatomic distribution of painful sunburns is similar in men and women, whereas the anatomic distribution of melanomas differ, it would appear that factors in addition to sunburns in adults account for the differences in the anatomic distribution of melanomas in men and women.
Epithelioid Sarcoma Presenting as a Benign Foot Ulcer
Authors: Tsao Hensin , Pennella Raffaele , Stiller Matthew J.
Published: July 2017

Background:

Epithelioid sarcomas are rare mesenchymal tumours that infrequently present to dermatologists. The often banal spindle and polygonal cell histology can mimic granulomas.

Objective:

Our aim is to raise the clinician's awareness of a potentially devastating malignancy that can remain unsuspected.

Method:

We present a case of an epithelioid sarcoma that was misdiagnosed as a benign foot ulcer and treated as such for nearly half a year. An uncertain histology further delayed definitive treatment. At the time of surgery, the tumour had infiltrated deeply.

Conclusion:

The often nondescript clinical and histologic nature of epithelioid sarcomas demands a high level of vigilance on the part of the clinician.
Genetic Studies in Skin Disorders, No. 1: Hair Today—Hair Tomorrow
Authors: Bale Sherri J.
Published: July 2017

Background:

A high-profile genetics journal published an article describing the mapping of a gene for the X-linked dominant disorder congenital generalized hypertrichosis.

Objective:

This article evaluates the data presented by Figuera et al. in their linkage-mapping study.

Methods:

The size of the candidate region defined by Figuera et al., the power of the data to identify candidate loci within the region, and the usefulness of the results for clinicians are evaluated.

Results:

The candidate region identified by Figuera et al. is extremely large, and these results will not be clinically useful.

Conclusion:

Despite what may have been presented in the lay press, identification of the gene for congenital generalized hypertrichosis is not imminent.
Rarity of Human Papillomavirus in Nonmelanoma Skin Cancer among Immunocompetent Patients
Authors: Karagas M.R. , Spencer S.K. , Weinstock Martin A. , Kuypers J. , Koff M. , Greenberg E.R.
Published: July 2017

Background:

The role of human papillomavirus (HPV) in nonmelanoma skin cancer (NMSC) among immunocompentent individuals is not well understood.

Objective:

We tested for the presence of HPV DNA in NMSC of immunocompetent patients from New England.

Methods:

Biopsies taken from 59 patients were reviewed histopathologically. A segment of the biopsy and scrapings from a site remote from the skin lesion were analyzed for HPV using a standardized polymerase chain reaction (PCR) DNA amplification assay.

Results:

Of 55 evaluable samples, 21 were histologically confirmed squamous cell carcinomas (SCC), 25 were basal cell carcinomas (BCC), and nine had other diagnoses. Two samples were HPV-positive (3.6%): a basal cell carcinoma of the forehead and a squamous cell carcinoma of the thumbnail bed. Type analysis of these samples revealed HPV 16 from both lesions.

Conclusion:

The HPV DNA is not commonly detected in NMSCs of immunocompetent patients using standard laboratory techniques. It is possible, however, that a wider range of HPV types could be detected using more sensitive assays; this warrants further investigation.
Defined System to Assess the in Vitro Induction of a Psoriasis Phenotype on Normal Keratinocytes by Fibroblasts from Psoriatic Subjects
Authors: Krueger Gerald G. , Jorgensen Cynthia M.
Published: July 2017

Background:

Research has shown that involved as well as uninvolved skin of psoriatic subjects have an inherent defect that manifests, at a minimum, as nonapparent epidermal hyperplasia. Fibroblasts have been shown to regulate epidermal proliferation and differentiation; furthermore, fibroblasts from patients with psoriasis have altered growth, response, and mediator release when compared with normal.

Objective:

We conjectured that it might be possible to generate the enhanced epidermal proliferation inherent to psoriatic skin in vitro using a defined interactive culture system with cellular components from the skin of normal and psoriatic subjects.

Methods:

To reduce the variables whereby fibroblasts stimulate keratinocyte proliferation in vitro, a system was developed that does not permit direct contact between keratinocytes and fibroblasts, but does permit the exchange of media and mediators as well as an assessment of keratinocyte growth as a function of time. Fibroblasts from involved and uninvolved sites from biopsies of seven untreated psoriatic subjects were assessed for their effect on the growth of keratinocytes from normal subjects.

Results:

Analysis shows that five of seven fibroblast sources from involved sites and six of seven from uninvolved sites of psoriatic subjects induce normal keratinocytes to display enhanced outgrowth. Three of 14 fibroblast sources consistently do not induce this change. Fibroblasts from uninvolved sources are particularly effective, with a mean of 40 ± 8% (SD) more growth than with normal fibroblasts.

Conclusion:

It is concluded that fibroblasts from psoriatics can induce the phenotype of increased epidermal proliferation on normal keratinocytes via a soluble mediator in a defined system.
Current Thoughts on the Use of Methotrexate in Patients with Psoriasis
Authors: Rosenthal Donald , Guenther Lyn , Kelly James
Published: July 2017

Background:

There are many problems associated with the use of methotrexate in the treatment of psoriasis.

Objective:

We will attempt to assist the clinician in resolving some of these problems.

Methods:

This article is a summary of a Round Table Discussion on methotrexate held at the Canadian Dermatology Association meeting at Whistler, BC, July 1995; of a Continuing Medical Education meeting on methotrexate at Langdon Hall, Cambridge, ON, May 1996; and our review of the pertinent literature.

Results:

We recommend routine folic acid supplementation in patients receiving methotrexate. A baseline pretreatment liver biopsy is probably not indicated in patients without clinical or laboratory evidence of liver disease; and patients on 15 mg or less of methotrexate per week with normal liver function may not need liver biopsy.

Conclusion:

Liver biopsy of patients on methotrexate for psoriasis may not be necessary.
Erythema Gyratum Repens Associated with Transitional Cell Carcinoma of the Bladder
Authors: Li Lian-Jie , Weinberg Jeffrey M. , Tangoren Ibrahim A. , Sleater Joseph P. , Klein Lynn M.
Published: July 2017

Background:

Erythema gyratum repens (EGR) is a gyrate erythema found in association with underlying malignancy, most commonly that of the lung, esophagus, and breast. Since 1952, there have been 51 cases of this condition reported.

Objective:

Only one case of EGR associated with transitional cell carcinoma of the bladder (TCCB) has been previously reported.

Methods:

The second case of EGR is the subject of a case report presentation.

Results:

An elderly patient presented with EGR and subsequent work-up revealed the presence of malignancy of the bladder.

Conclusion:

Erythema gyratum repens can be found in association with a variety of malignancies, including TCCB.
Follicular Lymphoma with Widespread Skin Lesions and Chromosome 14;18 Translocation in the Skin
Authors: Ho Vincent C. , Almofadhi Ali , Tron Victor A.
Published: July 2017

Background:

We report a case of systemic follicular B-cell lymphoma presenting with widespread skin lesions.

Objective:

The clinical features, histology, and treatment of primary and secondary cutaneous follicular lymphomas are discussed.

Conclusion:

The demonstration of chromosome 14; 18 translocation in the skin that is commonly found in primary, but rare in secondary, cutaneous follicular lymphoma can be helpful in confirming the diagnosis.
True Electrocautery in the Treatment of Syringomas and other Benign Cutaneous Lesions
Authors: Langtry James A.A. , Carruthers Alastair
Published: July 2017

Background:

A number of methods to treat benign cutaneous lesions are available, including surgical excision, electrosurgery, chemical cauterizing agents, cryotherapy, and carbon dioxide laser vaporization. Electrocautery has been used for more than a century and is in danger of becoming a forgotten treatment modality.

Objective:

The aim of this review is to describe the procedure of electrocautery and bring attention to this treatment method.

Methods:

The principles of electrocautery and our experience in selected cases are reviewed.

Results:

Excellent results were achieved using electrocautery to treat syringomas, linear epidermal nevus, and dermatosis papulosa nigra.

Conclusion:

Electrocautery is a useful technique for treating selected benign cutaneous lesions and should not be discarded in the rush to embrace new technologies.
Idiopathic Atrophoderma of Pasini and Pierini
Authors: Braun Alicia , Poulton James , Kauffman C. Lisa
Published: July 2017

Background:

Idiopathic atrophoderma of Pasini and Pierini (LAPP) is a rare pattern of dermal atrophy, with less than 300 cases reported worldwide. Currently, there is controversy surrounding the classification of LAPP; some consider it to be a variant of morphea, while others view it as a separate disease entity.

Objective:

Our purpose was to further elucidate the nature and course of this unusual disease.

Methods:

We present a case report, with long-term follow-up of a case of IAPP of 30 years' duration.

Results:

The patient's lesions were primarily atrophic, without progression to morphea, scleroderma, or other systemic disease. Biopsy of a long-standing plaque demonstrated dermal thinning, and minimal dermal infiltrate.

Conclusion:

This case supports the findings of the literature on this subject: the majority of patients with IAPP have an entirely benign course, without progression to other disease.
Genetic Studies in Skin Disease Research: Flare-up of Psoriasis Genes
Authors: Bale Sherri J.
Published: July 2017

Background:

The chromosomal location of several genes for familial psoriasis has recently been reported.

Objective:

This article reviews these recent reports of genetic linkages in psoriasis.

Methods:

An explanation and discussion of the type of family material studied and the statistical approaches used are presented.

Results:

Linkage of psoriasis-susceptibility loci have been reported on chromosomes 17, 4, and 6.

Conclusion:

Due to genetic heterogeneity and decreased penetrance, confirmation of reported genetic linkages is likely to be difficult. The use of single, large families in which many members are affected with psoriasis may yield the most information.
Lymphoid Markers, Activation Markers, and Adhesion Molecules in Cutaneous Biopsy Specimens from HIV+ Patients with Disease Progression
Authors: Smith Kathleen J. , Skelton Henry G. , Yeager Josef , Baxter Donald , Nelson Ann T. , Angritt Peter , Chu Wei-Sing , Wagner Kenneth F ,   Military Medical Consortium for the Advancement of Retroviral Research
Published: July 2017

Background:

One important factor in understanding the pathogenesis of human immune deficiency virus (HIV) disease is documenting the patterns of immune dysregulation present in HIV-positive patients. The cells which home to skin are mainly certain subsets of T cells and, as opposed to the peripheral blood, where circulating factors may inhibit terminal phenotypic differentiation, the cutaneous environment potentiates differentiation during cutaneous eruptions.

Objective:

The authors' aim was to characterize the inflammatory dermatoses in biopsy specimens from HIV-positive patients with immunohistochemical stains for lymphoid markers, activation markers, and adhesion molecules and to determine if there was any correlation with the type of dermatosis and the HIV-disease stage.

Methods:

Lymphoid and activation markers as well as adhesion molecules were studied on cutaneous biopsy specimens from 96 inflammatory dermatoses in HIV-positive patients. The dermatoses included psoriasiform dermatoses with and without a lichenoid component, perivascular lymphoid dermatoses, perivascular and periadnexal inflammatory dermatoses, spongiotic dermatoses, granulomatous dermatoses, and neutrophilic dermatoses with and without vasculitis.

Results:

Although there was a decrease in CD4/CD8 ratios in the cutaneous inflammatory dermatoses with progression of the disease, the ratios of CD4/CD8 cells were far higher than those in the peripheral blood. There were also increasing numbers of CD23+ cells and increased E-Selectin expression on endothelial cells from the early stages of disease, with no consistent pattern of ICAM-1 expression on epithelial cells with disease progression.

Conclusions:

The expression of lymphoid markers, activation markers, and adhesion molecules in the skin with progression of HIV disease, is consistent with a T helper (Th)1 to Th0/Th2 cytokine pattern of immune dysregulation. This cytokine pattern may be modified by the cytopathic effects of HIV on lymphoid and dendritic populations and by effects of other concurrent infections. Significant numbers of CD4+ T cells in skin infiltrates, with low peripheral CD4 T-cell counts, suggest that the cutaneous T-cell populations may be distinctive.
Phase 1 Clinical Trials
Authors: Muglia Jennie J. , DiGiovanna John J.
Published: July 2017

Background:

In the United States, drug development and approval is a complex process regulated by the Food and Drug Administration under the authority outlined in the Code of Federal Regulation. The goal of this multi-step process is to determine safety and efficacy of new therapeutic entities. Initially, exposure of humans to new therapeutic agents is accomplished in a graded and limited fashion. This approach seeks to minimize risks to study participants from exposure to damaging agents. During early phases, limiting exposure to a few individuals results in the accumulation of preliminary data on pharmacology, short-term toxicity, and efficacy. The inherent limitations of this process necessitate careful critique and caution in extrapolation of phase 1 data.

Objectives:

The purpose of this article is to provide a review of the drug approval process focusing on phase 1 trials, which are the earliest human exposure to a new drug. The purpose, variations, and significance of phase 1 trials are described, and a framework is provided to critically evaluate data published from these trials.

Conclusions:

Phase 1 trials are primarily designed to accumulate short-term safety (toxicity) and pharmacological data. Although preliminary efficacy may be addressed (“proof of concept” efficacy), it is a secondary endpoint. The numbers of patients are small, the numbers of patients receiving efficacious doses are very small, and controls are absent. Evaluation of efficacy and of long-term toxicity requires longer, larger, and controlled studies.
Androgen Receptor Polymorphisms (CAG Repeat Lengths) in Androgenetic Alopecia, Hirsutism, and Acne
Authors: Sawaya Marty E. , Shalita Alan R.
Published: July 2017

Background:

The androgen receptor (AR) is a structurally conserved member of the nuclear receptor superfamily. The amino-terminal domain is required for transcriptional activation and contains a region of polyglutamine encoded by CAG trinucleotide repeats. In humans, the number of CAG repeats is polymorphic. Expansion of CAG repeats in the AR has clinical implications for human disease.

Objective:

Androgens influence androgenetic alopecia (AGA), hirsutism, and acne; the polymorphisms in CAG repeat length may affect the clinical course of patients with these cutaneous disorders. The purpose of this study is to test for an association between these disorders and CAG repeat length.

Methods:

We analyzed normal lymphocyte genomic DNA from a total of 48 men and 60 women. The CAG repeat region of the AR was amplified by polymerase drain reaction (PCR) and the products were sized on polyacrylamide gels.

Results:

In normal men and women controls, a range of 12 to 29 trinucleotide repeats was found, with men having 22 ± 4 (M ± SD), women 21 ± 3. Men with AGA had 19 ± 3, whereas women with AGA had 17 ± 3. Men with acne had 21 ± 3, whereas women had 20 ± 3; men with AGA and acne had 18 ± 4; and women with hirsutism had 16 ± 3. Women with a combination of at least two disorders also had 16 ± 3 trinucleotide repeats.

Conclusion:

Shorter CAG-repeat lengths may be associated with the development of androgen-mediated skin disorders in men and women. These data suggest that CAG-repeat length in AR may affect androgen mediated gene expression in hair follicles and sebaceous glands in men and women with these androgenic skin disorders.
Immunophenotyping of a Sarcoidal Granuloma in a Scar, a Manifestation of a Possible Autoimmune Process
Authors: Morhenn Vera B. , Smoller B. R.
Published: July 2017

Background:

Old scars rarely develop sarcoid lesions. To determine whether the immunophenotype of the cellular infiltrate found in sarcoid in scarred skin resembled that seen in sardoidosis, we performed routine staining with hematoxylin and eosin, as well as immunophenotyping of a sarcoid lesion in a scar. Currently, there is controversy about the etiology of sarcoidosis in general and about sarcoidal granulomas in scars in particular. A new hypothesis is suggested in this case report.

Objective:

The purpose was to determine whether the cellular infiltrate in a sarcoidal granuloma in an old scar was similar to that in sarcoidosis.

Methods:

Staining with hematoxylin and eosin as well as immunophenotyping was performed using standard techniques.

Results:

The dermis of the sarcoid lesion demonstrated predominantly macrophages, followed by CD-4+ T-helper cells. CD-8+ cytotoxic suppressor cells were rare.

Conclusions:

The lymphoid cell infiltrate in a sarcoidal granuloma found in a scar is similar to that found in sarcoidosis. Furthermore, the staining pattern of sarcoid described in this paper and a review of the data in the literature suggest that sarcoidosis shares many characteristics of diseases with an autoimmune origin. Thus, we suggest that sarcoid isolated to scars represents a more benign variant of sarcoidosis, a possible systemic autoimmune disease.
Sun-Protective Clothing
Authors: Adam John
Published: July 2017

Background:

Topical sunscreens have been used for many years on exposed areas (i.e., hands, face) to protect the skin from the damaging effects of ultraviolet radiation. Most people do not use sunscreens on their bodies when they are wearing clothes. An average weight cotton T shirt gives only a sun protection factor (SPF) of 7. This is inadequate protection when out of doors. Therefore, clothing with adequate sunscreening properties should be worn.

Objective:

The purpose of this study is to identify the factors in clothing fabrics that contribute to or detract from blocking ultraviolet radiation and to recommend criteria for establishing a standard for sunprotective clothing.

Method:

The study involves a review of the dermatologic and textile literature to identify various factors in fabrics that contribute to blocking ultraviolet radiation through textiles.

Conclusion:

For fabrics, the term ultraviolet protection factor (UPF) is used as the measure of ultraviolet radiation penetration through the fabric. The UPF of a fabric depends upon fiber content and weave, fabric colour, finishing processes, and the presence of additives. The performance of a fabric depends upon stretching, shrinkage, hydration, laundering, and wear of the fabric over time. Based upon these criteria the minimum CDA standard UPF for clothing should be 40 to 50+.
Sunlight Exposure, Hat Use, and Squamous Cell Skin Cancer on the Head and Neck
Authors: Bajdik Chris D. , Gallagher Richard P. , Hill Gerry B. , Fincham Shirley
Published: July 2017

Background:

Sunlight is the environmental exposure most often associated with squamous cell cancer (SCC) of the skin. It can be difficult to quantify the sunlight exposure of the skin because of the different types of clothing that may be worn. The problem is simplified for studies of SCC on the skin of the head and neck, where a hat is the only type of clothing that needs to be considered.

Objective:

The purpose of the study was to determine the risk for SCC of sunlight exposure on the skin of the head and neck, and the protective effect, if any, associated with wearing a hat.

Methods:

A case-control study of squamous cell carcinoma of the skin was conducted amongst men in the province of Alberta, Canada. Analysis was restricted to only those cases where cancer occurred on the head or neck, and their age and sex matched controls.

Results:

Ethnicity, non-sunexposed skin colour, and hair colour each significantly affected the SCC risk. An increased SCC risk was also associated with greater cumulative sunlight exposure and with sunburns experienced during the ages 5 to 15 years. The risk associated with sunlight exposure was significantly elevated in men who reported that they had always or usually worn a hat.

Conclusion:

As observed in previous studies, SCC on the skin of the head and neck is associated with host pigmentation, sunburns occurring in childhood, and sunlight exposure during adulthood. The risk observed for wearing a hat may be due to bias or confounding; however, hats remain an unproven means of protection against SCC on the skin of the head and neck.
Lichenoid/Interface Cutaneous Eruptions to IVIg with the Primary Infusion May Be Related to the Re-Regulation of Anti-Idiotype Network
Authors: Smith Kathleen J. , Dutka Andrew L. , Skelton Henry G.
Published: July 2017

Background:

Intravenous immunoglobulin (IVIg) has been used in recent years to treat an increasing number of autoimmune diseases to decrease cytokine secretion and to neutralize toxins, in addition to the therapy of immunodeficiency disorders. In addition to angioedema-like hypersensitivity eruptions, there have been reports of eczematous, purpuric, petechial/purpuric, and vasculitic reactions to IVIg; however, there has been only one previous report of a case in which the patient developed a lichenoid dermatitis after infusion of IVIg.

Observations:

We present two patients with chronic inflammatory, demyelinating polyneuropathy, who after the first course of IVIg developed a folliculocentric interface/lichenoid eruption that cleared without therapy or with topical steroids. The eruption did not recur with subsequent IVIg infusions in either patient.

Conclusions:

The multiple diverse effects of IVIg on the immune system, and the re-regulation of the anti-idiotype network with repeat IVIg infusions, may explain why this eruption occurred with the initial infusion of IVIg and not with repeated infusions.
Junctional Epidermolysis Bullosa with Pyloric Atresia: A Case with Favourable Outcome
Authors: Ha Duc , Idikio Halliday , Krol Alfons , Lin Andrew N.
Published: July 2017

Background:

Pyloric atresia is a rare but serious condition that can occur with junctional epidermolysis bullosa (PA-JEB). Early recognition is necessary for timely intervention, but prognosis can be serious and mortality is high.

Objective:

We describe the case of a patient with PA-JEB who not only survived past infancy, but showed improvement in cutaneous blistering as she grew older.

Conclusion:

With early surgical intervention, some patients with PA-JEB can survive and look forward to a favourable prognosis, with improvement of cutaneous blistering by early childhood.
Sun and the Skin: Evaluation of a Sun Awareness Program for Elementary School Students
Authors: Gooderham Melinda J. , Guenther Lyn
Published: July 2017

Background:

Research suggests that childhood exposure to ultraviolet radiation is a significant risk factor for the development of melanoma and nonmelanoma skin cancers. Sun awareness education programs for children can positively influence children's sun protective practices to decrease the risk of skin cancer.

Objective:

The purpose of this study was to evaluate a sun awareness education program, entitled “Sun and the Skin” that had recently been developed and implemented in London, Ontario.

Method:

The study uses a pre- and posttest design to evaluate both knowledge and behaviour of Grade 4 students participating in the program at baseline, immediately after, and 1 month after the program.

Results:

The students demonstrated a significant increase in their sun-protective practices after participation in the “Sun and the Skin” program. There was a significant improvement in the students' level of knowledge after the program. Improvement in both behaviour and knowledge were maintained weeks after completion of the program. Minor differences in knowledge due to demographic characteristics were detected after the program.

Conclusions:

A sun awareness education program for Grade 4 students can improve both their knowledge and behaviour over time. This format should be used in conjunction with changes in school policy in order to make a significant longterm impact.
Parry-Romberg Syndrome with Contralateral and Ipsilateral Extremity Involvement
Authors: Chapman M. Shane , Peraza Jose E. , Spencer Steven K.
Published: July 2017

Background:

The Parry-Romberg syndrome is an acquired progressive hemifacial atrophy involving the subcutaneous tissues of the scalp and face. Involvement of the extremities is uncommon in this syndrome.

Objective:

A case of contralateral and ipsilateral extremity involvement in the Parry-Romberg syndrome is reported, and the difficulties in distinguishing this syndrome from linear scleroderma en coup de sabre are reviewed.

Methods:

A MEDLINE search for cases of Parry-Romberg syndrome with contralateral extremity involvement was performed and the cases reviewed.

Results:

Contralateral extremity involvement in the Parry-Romberg syndrome is rare.

Conclusion:

This may be the first case reported in the English literature of Parry-Romberg syndrome with contralateral and ipsilateral extremity involvement.
Three Point-Advancement Closure for Skin Defects
Authors: Tamir Gabriel , Birkby Craig S. , Berg Daniel
Published: July 2017

Background:

Circular skin defects are common following Mohs' surgery. Traditional closure (primary, flap, or graft) may involve extensive surgery. Multidirectional advancement closures such as the purse-string closure have been advocated as another useful tool in such cases.

Objective:

To describe a variation on purse-string closure that, in certain cases, is an excellent alternative to other reconstructions, and will provide good cosmetic and functional outcome.

Method:

A three-point anchoring suture is placed after undermining to advance the surrounding tissue toward the centre, creating a “Mercedes Benz” or tripod closure following removal of “dog-ears.”

Results:

Circular wounds in designated areas can be more easily closed, creating well-tolerated, favourable scars.

Conclusion:

Large wounds may be closed with the advantage of avoidance of larger flaps, of decreased wound healing compared to second intention, and of minimizing removal of healthy tissue. An initial trial of closure with this method does not limit subsequent use of other repairs should it be less than satisfactory.
Comparative Irritancy Study among Retinoid Creams and Gels
Authors: Toole J. W. P. , Lockhart Leslie , Potrebka Joelle , Bowman James P. , Novack Gary D.
Published: July 2017

Background:

Topical retinoids, although very useful in dermatology, may be irritating to some patients.

Objective:

There are a number of topical retinoids available in Canada, and the objective of the present study was to evaluate the irritancy potential in humans of retinoid gels and creams presently available in Canada.

Methods:

Thirty healthy adults were administered 10 products (five creams, three gels, petrolatum, and sodium lauryl sulfate (SLS) 0.1% w/v) for up to 21 consecutive days.

Results:

Early termination of patching due to irritation was required for the tretinoin creams and gels and SLS more frequently and earlier in the study than for adapalene and petrolatum (p = .001). Statistically significant, among-group differences were noted in the severity of irritation at each day and for the cumulative score for both the creams and the gels (p = .0001), in favour of adapalene over the tretinoin products.

Conclusion:

By several measures, adapalene cream and gel were less irritating upon multiple dosing than various tretinoin creams and gels.
Of Hairless Mice and Men: The Genetic Basis of Congenital Alopecia Universalis/Congenital Atrichia
Authors: Bale Sherri J.
Published: July 2017

Background:

Mouse models of human diseases help identify gene defects.

Objective:

The methods of homozygosity mapping and mouse/human homology to identify genes are reviewed. The genotype/phenotype correlation in two clinical entities with mutations in the human hairless gene are discussed.

Methods:

The example of the hairless mouse's contribution to our knowledge of hereditary alopecia is used, and the utility of consanguineous families for genetic studies is highlighted.

Results:

Mutations in the human homolog of the mouse hairless gene lead to congenital alopecia universalis and atrichia with papules.

Conclusion:

A mouse model of congenital alopecia has led to understanding the molecular basis of at least one type of severe human alopecia.
Trichoepithelioma Associated with Cellular Blue Nevus
Authors: Al-Ghamdi Abdulmonem M. , Trotter Martin J.
Published: July 2017

Background:

Epithelial elements, such as trichoepithelioma, are occasionally associated with melanocytic nevi.

Objective:

A case of trichoepithelioma in association with cellular blue nevus is reported.

Methods and Results:

A solitary, pigmented nodule was removed from the scalp of a middle-aged woman. Histopathologic examination demonstrated a circumscribed cellular blue nevus within which were embedded epithelial strands and cystic structures consistent with trichoepithelioma.

Conclusion:

Trichoepitheliomas have been described in relation to common acquired nevi, but an association with a blue nevus is rare. The intimate admixture of trichoepithelioma within the nodule of a nevus supports the concept of epithelial induction by melanocytic nevi.
Horseless Carriage & Cracked Mirror: The Electronic Media in the Pacific Islands
Authors: Hill Helen
Published: July 2017

Some of the problems of television, I believe, are the result of the uncritical transplantation of certain of the norms of radio. It is something like the early automobile, which was designed with features of its predecessor, the horsedrawn carriage … I want to argue that the carriage is not only horseless but driverless as well … it is my impression that television (especially in new and small nations) goes off on its own way, despite the best efforts of often capable and willful people. Television in new nation X, with all that nation's aspirations for indigenous cultural creativity seems to want to be like television everywhere else, and nobody seems able to stop it. Elihu Katz, ‘Television as a Horseless Carriage’, (1973 p381)

Perhaps the most useful contribution TV can make to a community is the opportunity it offers for increased self-awareness. By ‘holding, up a mirror’ for a society, more effectively than any other medium, TV vastly increases the flow of information, ideas, entertainment, opinion, and can encourage involvement by all levels of society in the development of a sense of identity. But this is only possible if local people have control of the medium and access to it. Ian Johnstone, ‘From Closed to Open Television in the South Pacific’, (1973, p7)

Colonialism is a communication system that presents cracked mirrors which distort reflections of our true selves. Lasarusa Vusoniwailala, Fijian Broadcaster, (1976, p4)

I think media are so powerful they swallow cultures. I think of them as invisible environments which surround and destroy old environments, Sensitivity to problems of culture conflict and conquest becomes meaningless here, for media conquers all cultures. One may pretend that media preserve and present the old by recording it on film and tape, but that is mere distraction, a sleight-of-hand possible when people keep their eyes focused on content. Edmund Carpenter, Communications consultant to New Guinea Administration (1973, pp190–191)
Asia & the Australian Media
Authors: Frost Frank
Published: July 2017

The 1980 controversy over the character of Australian reporting on Indonesia, notably East Timor, and Radio Australia's broadcasts to Indonesia was a major stimulus for an October 1981 Australian Institute of International Affairs (Canberra Branch) Conference.

The 19 speakers — Australian and Asian journalists and academic specialists on Asia and on media — and 200 participants paid a lot of attention to these issues. But they were discussed in a broader context: Australian media reporting of Asia; the presentation of Australia in Asian media; reforms in the collection and distribution of international and especially developing countries news; and Asian news and the Australian public. This paper reviews the major strands of the Conference.
The Formation of Attitudes to Foreign Countries
Authors: Hedman Lowe
Published: July 2017

Recent Swedish research shows: 1. Journalists and opinion makers have a more favourable attitude to the Third World than has the general public, but fail in transmitting this to the public. 2. Increased exposure in mass media increases Third World orientation in terms of knowledge, interests and activity. However, lower strata acquire only interest. They derive little knowledge or activity from the media nor do they show a favourable attitude to development aid. The scanty coverage of structural-historical reasons for Third World problems may be responsible. Journalists themselves do not believe that media enable the general public to acquire a good knowledge of international relationships. 3. Large circulation papers give relatively much more adequate background information and explanation of events in the Third World than do local and regional ones. Resource differences are important.
Third World Mass Communications: A Basic Bibliography
Authors: Lent John A
Published: July 2017

To produce a selected bibliography on Third World mass communications has become rather difficult in recent years, because of an abundance of materials. The controversy that led to and nourished the New World and International Information Order augmented the literature by many fold and in some cases impressively — though not always differently, as catch phrases and arguments on all sides of the debate were repeated almost slavishly in packaged articles and books reminiscent of the works of a public relations practitioner. The growth of journalism training, research and educational institutions — and a corresponding increase in teachers, researchers and writers — in Third World nations also produced a glut of information.

Because of these factors and a space limitation, this bibliography is devoted almost entirely to books and monographs published between 1971 and 1981. A list of periodicals which carry Third World mass communications articles is added, with notations on special issues devoted to the topic. To do more than this concerning periodical literature is prohibitive in this article.

Categories used are bibliographies; mass communications, broken down into general, advertising and public relations, broadcasting, film and press; communication and development in the Third World (including media's role in social change, national development and integration, rural development and revolutionary movements); communications, politics and governments in the Third World (including law of the press, political processes and ideologies, right to communicate and press freedom); and the New World and International Information Order and the Third World (including media imperialism, flow of news and information and national sovereignty).

This listing in no way is meant to be exhaustive; instead, it is designed to serve as a basic bibliography of the most recent books and monographs written by researchers and scholars throughout the world, but mainly from the United States.
Third World Mass Communications: Journal Article Abstracts
Authors: Moore Tony
Published: July 2017

As a resource for those wishing to pursue further research in this area, Media Information Australia commissioned Tony Moore to produce a compilation of abstracts of articles on media in the Developing World which have appeared in media and development journals over the past two years. The articles were culled from journals available in NSW. The list is not exhaustive, but it is hoped that it will prove to be a valuable research tool.
Advertising and Social Reality: A Point of View
Authors: Still Leonie V
Published: July 2017

One of the basic philosophical issues still not resolved in current advertising practice is whether advertising should ‘reflect’ or influence’ the current social environment. Advertising professionals, especially the chief executives of advertising agencies, favour the ‘reflective’ position because of the practicalities of everyday marketing. The loss of a client's account will usually result in the loss of millions of dollars in billings for an agency. This is a high price to pay if a client considers a campaign to be an unfashionable moral crusade or a display of unfettered licence in the intricacies of an esoteric art.