bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pancreatic Panniculitis Associated with Acinar Cell Pancreatic Carcinoma
Authors: Poelman Susan M. , Nguyen Khue 
Published: October 2018

Background: Pancreatic panniculitis is a rare entity, occurring in less than 2% of patients with pancreatic disorders. Skin manifestations may precede the diagnosis of a pancreatic disease by many months. When treatable, correction of the underlying pancreatic disorder may lead to prompt resolution of the panniculitis. Objective: We present the case of a 74-year-old-man with a history of chronic pancreatitis who presented with an acute onset of tender, nonulcerating nodules. The clinical and histologic features of pancreatic panniculitis are discussed, with a brief review of the differential diagnosis and clinical approach to panniculitis. Conclusions: Pancreatic panniculitis is a recognizable clinical entity with characteristic histologic features that may resolve with treatment of the underlying pancreatic disorder. The algorithm-based clinical approach to panniculitis presented in this study is a practical tool designed to guide clinicians in ordering investigations and determining the appropriate management for patients presenting with subcutaneous nodules.
Nevus Lipomatosus Superficialis Unseen or Unrecognized: A Report of Eight Cases
Authors: Kumaran Muthu Sendhil , Narang Tarun , Dogra Sunil , Saikia Uma Nahar , Kanwar Amarinder Jit 
Published: October 2018

Background: Nevus lipomatosus superficialis (NLS) is a unique developmental anomaly or nevoid form of lipoma characterized by the ectopic presence of mature adipocytes in reticular dermis. The condition is rare; apart frrom isolated case reports, there are no large case series dealing with the clinicoepidemiologic characteristics and posttreatment long-term follow-up in patients with NLS and little published information on treatment outcome. Objective: To study the clinicoepidemiologic characteristics and long-term posttreatment follow-up in patients with NLS. Methods: This was an 11-year retrospective study analyzing disease characteristics and treatment outcome in eight patients with NLS. Results: There were eight (six males, two females) patients with NLS, of whom three were children. The classic variant of NLS was the predominant presentation. One patient demonstrated a combination of both classic and solitary variants. Most patients, especially those with solitary variants, were commonly misdiagnosed before presenting to us. Four patients, including two with the solitary variant, one each with the classic and the combined type, underwent surgical resection without any recurrence over 8 years of follow-up. Conclusions: The rare nature of the disorder, which is commonly misdiagnosed, and the absence of long-term follow-up data prompted us to share our experience about NLS to increase its awareness among health care providers.
An Update on Chronic Wounds and The Role of Biofilms
Authors: Scali Christina , Kunimoto Brian 
Published: October 2018

Background: Chronic wounds cause significant morbidity and mortality and cost our health care system millions of dollars each year. A major impediment to wound healing is the formation of bacterial biofilms. Biofilms are communities of bacteria associated with chronic infections. Objective: This article reviews the literature on chronic wounds and biofilms. The role of biofilms in chronic wounds is not widely known. The purpose is to increase awareness of their role and to discuss research into novel therapeutic options. Methods: PubMed searches were performed to identify publications on chronic wounds and biofilms. Results: Biofilms contribute to chronic wound nonhealing. There is an abundance of research into novel antibiofilm strategies for chronic wounds. Conclusion: Current research is being targeted at antibiofilm strategies needed to restore an optimal wound-healing environment. A combined treatment approach involving aggressive débridement and the addition of antibiofilm agents is needed.
Dermabrasion and Staged Excision of Facial Lesions in a Neurofibromatosis Case for Improvement of Facial Appearance
Authors: Karabekmez Furkan Erol , Duymaz Ahmet , Karacor Zeynep 
Published: October 2018

Background: Neurofibromatosis may present with different skin lesions. Disfiguring lesions on the face might be challenging for the surgeon or clinician to correct and may have adverse effects on patients' social lives, especially in young women. Objective: To present the dermabrasion technique combined with serial excisions of a deeper accompanying lesion to treat superficial facial lesions in a young neurofibromatosis patient. Methods: Dermabrasion was applied to superficial lesions on the face, and staged excision was applied to the deeper lesion located on the forehead. Results: We obtained high patient satisfaction with the result. The deep lesion was excised totally, and superficial lesions were decreased with dermabrasion. Conclusion: Dermabrasion may become a good alternative in cases of neurofibromatosis with superficial facial lesions.
Favre-Racouchot Syndrome in a 39-Year Old Female following Radiation Therapy
Authors: Sutherland Ashley E. , Green Peter J. 
Published: October 2018

Background: Favre-Racouchot syndrome is a cutaneous disease characterized by nodules, cysts, and comedones that typically develops on sun-exposed areas of the face. This syndrome most commonly affects white males between the ages of 40 and 60 years and is frequently associated with chronic sun exposure and, more recently, chronic cigarette smoking. Objective: We report a case of Favre-Racouchot syndrome in a 39-year-old female who received 6 weeks of radiation therapy to treat a grade 3 oligodendroglioma. Results and Conclusion: Although there have been previously reported cases of Favre-Racouchot syndrome following radiation therapy, this case is unique given the young age of the patient and extent of involvement.
Scalp Trauma
Authors: Montpellier Renee-Anne , Donovan Jeff C. 
Published: October 2018

Background: Lichen planopilaris is a type of primary scarring alopecia that is characterized by perifollicular lymphocytic inflammation and fibrosis. The cause remains poorly understood, although recent research has begun to unravel some of the molecular mechanisms implicated in the pathogenesis. Objective: To present a case of biopsy-proven lichen planopilaris in a patient who had previously suffered serious head injury. Lichen planopilaris developed only in the areas of trauma. Conclusion: Our findings highlight the possible association between scalp trauma and the development of lichen planopilaris. Further research is needed to understand the role of scalp trauma in the pathogenesis of scarring alopecia.
Eosinophilic Fasciitis Occurring under Treatment with Natalizumab for Multiple Sclerosis
Authors: Bujold Janie , Boivin Catherine , Amin Mohamed , Bouchard Jean-Pierre , Soucy Jacques 
Published: October 2018

Background: Eosinophilic fasciitis is a rare sclerosing syndrome with a poorly understood etiology. Objective: We report a case of eosinophilic fasciitis in a 40-year-old man undergoing treatment with natalizumab for multiple sclerosis. Natalizumab is a selective adhesion molecule inhibitor that prevents interaction of leukocytes with endothelial cells. Peripheral blood eosinophilia has been described under treatment with natalizumab, but we herein report the first case to our knowledge of eosinophilic fasciitis as a possible complication of this medication.
Eruptive Melanocytic Nevi Induced by Interferon for Nodal Metastatic Melanoma: Case Report and Review of the Literature
Authors: Salopek Thomas G. , Mahmood Muhammad N. 
Published: October 2018

Background: The rapid appearance of multiple new melanocytic nevi is known as eruptive nevi and has been well documented to occur with certain medications, in particular chemotherapeutic agents. Methods: We report a case of a woman with melanoma complicated by nodal metastasis who developed multiple melanocytic nevi while on high-dose interferon. Results: Serial photographs confirmed that the pigmented lesions were of new onset, whereas histology documented that the lesions were dysplastic nevi. A survey of the literature documented numerous causes of eruptive nevi, which we review. To date, interferon has not been linked to eruptive nevi. Conclusions: The phenomenon of eruptive nevi has been attributed to medications, bullous dermatoses, immunosuppression, and systemic conditions and is possibly a paraneoplastic disorder. Interferon appears to be another possible cause of this disorder.
External Tissue Expander for Closing Large Defects of the Extremities and Trunk
Authors: Kirschke Julia , Georgas Dimitrios , Sand Michael , Bechara Falk G. 
Published: October 2018

Background: Direct closure is the reconstruction of choice for surface soft tissue defects; however, it may not be suitable for larger defects due to extensive tension. A variety of techniques are available for achieving tension free closure, including skin grafts, skin flaps, and internal or external tissue expansion. Materials and Methods: The external skin expander developed by Blomqvist and Steenfos consists of single tissue expander units that contain an atraumatic needle and two friction stoppers connected via a silicone string. Each device of the expander is inserted under local anaesthesia on each side of the defect at a distance of about 2 cm from each other. Postoperative the silicone strings have to be tightened at least once a day. After about 5 to 10 days a sufficient expansion is achieved and the defect can be closed directly after expander removal. Results: The external tissue expander developed by Blomqvist and Steenfos is an efficient, time-effective, easy-to-handle device that can be inserted under local anesthesia, providing a good functional and satisfactory cosmetic outcome. Due to the comparatively low complication rate, even outpatient treatment is possible. The major drawback of this technique is the possibility of developing uncommon secondary scars under the plastic stoppers.
Cutaneous T-Cell Lymphoma–Like Drug Eruption in an HIV-Positive Patient Taking Vancomycin and Rifampin
Authors: MacIsaac Jennifer L. , Ward Chloé E. , Pratt Melanie 
Published: October 2018

Background: Cutaneous T-cell pseudolymphoma (CTPL) is a benign reactive T-cell lymphoproliferative subtype of pseudolymphoma. Some variants of CTPL can resemble the plaques of mycosis fungoides (MF). The vast majority of drug-induced cases have been associated with anticonvulsants. There is only one report in the literature documenting a case of vancomycin-induced CTPL. Methods: We report a cutaneous T-cell lymphoma–like eruption in a human immunodeficiency virus (HIV)-positive patient recently started on vancomycin and rifampin. Results: A skin biopsy showed several histologic features of MF with immunohistochemical and T-cell receptor gene rearrangement studies suggestive of CTPL. This atypical T-cell reaction mimicking MF completely resolved on cessation of rifampin followed by vancomycin. Conclusion: Considering drug-induced causes of MF-like histologic changes is crucial to prevent unnecessary treatment for MF.
Spectrum of Dermoscopic Patterns in Lichen Planus: A Case Series from China
Authors: Tan Cheng , Min Zhong-Sheng , Xue Yanning , Zhu Wen-Yuan 
Published: October 2018

Background: Dermoscopy has been shown to be a promising method to facilitate the diagnosis of lichen planus (LP) outside of China. Objective: To investigate the spectrum of dermoscopic patterns in Chinese LP patients. Methods: The clinical data and dermoscopic patterns of nine LP cases with a total of 43 lesions were evaluated. Results: To the naked eye, 20.97% of the lesions exhibited graying Wickham striae (WS); however, 37.5% presented with white streaks of annular, reticular, or leaf venation patterns under dermoscopy. Blue-white veils were occasionally observed in the center. Pigment patterns varied from dots, globules, and peppered pigment to pigmented lines, which were unrelated to the pigment network of the skin. At the periphery of the WS, red fine lines ran parallel to the delicate white streaming lines. Conclusions: WS exhibits five morphological patterns (leaf venation, reticular, white dots, circular and radial streaming) and three color patterns (homogeneous crystalline white, blue-white veil and yellowish-white). The pigment patterns consisted of dots/globules, peppered pigments and pigment. streaming lines.
Efficacy of Topical Calcineurin Inhibitors in Psoriasis
Authors: Wang Cong , Lin Andrew 
Published: October 2018

Background: Topical calcineurin inhibitors (tacrolimus and pimecrolimus) are indicated for the treatment of atopic dermatitis but ve also been studied in the treatment of psoriasis. Objective: To define the efficacy of topical calcineurin inhibitors in the treatment of psoriasis. Methods: We searched for English-language articles published since 1990 in PubMed, Ovid/Cochrane, and Embase using “tacrolimus,” “pimecrolimus,” or “topical calcineurin inhibitors” and “psoriasis.” Results: Nine double-blind and 13 open studies demonstrated the efficacy of topical tacrolimus in psoriasis, especially for facial, genital, and intertrigious psoriasis, and four double-blind and one open study demonstrated the efficacy of topical pimecrolimus. Conclusions: The evidence (double-blind and open studies) is strong that topical tacrolimus and, to a lesser extent, pimecrolimus have efficacy in the treatment of psoriasis. Since these agents do not cause cutaneous atrophy, they likely have a special role in facial, genital, and intertriginous psoriasis. Further studies would help define their roles in psoriasis.
Complete Skin Resection of the Dorsum of the Hand: A Prophylactic Approach Using a Dermal Regeneration Template
Authors: Hessam Schapoor , Georgas Dimitrios , Sand Michael , Bechara Falk G. 
Published: October 2018

Background: Surgical treatment of multiple and recurring invasive carcinomas on the dorsum of the hand often results in a reconstructive challenge. Reconstruction is limited due to reduced adjacent tissue. Preserving the functionality of the hand is pivotal and needs to be respected while planning reconstruction. Objective: We present a case of extensive, multiple, and recurring invasive squamous cell carcinoma on the dorsum of the hand and describe a prophylactic surgical approach. Methods: We performed a radical excision of the skin on the dorsum of the hand and surgical reconstruction using a bilayer dermal skin substitute and split-thickness skin grafting. Results: After a 1-year follow-up, we observed an excellent cosmetic and functional result with no signs of recurrence. Conclusions: In case of extensive invasive squamous cell carcinoma on the dorsum of the hand, prophylactic resection and surgical reconstruction using a dermal regeneration template should be considered.
Hospitalizations for Cellulitis in Canada: A Database Study
Authors: Baibergenova Akerke , Drucker Aaron M. , Shear Neil H. 
Published: October 2018

Background: Cellulitis is the skin disease most commonly responsible for emergency department visits and inpatient admissions. Objective: To determine factors associated with prolonged admissions and mortality in inpatients with cellulitis. Methods: Data on patients with an admission diagnosis of cellulitis from 2004 to 2008 in the Canadian Discharge Abstract Database were analyzed. Factors associated with mortality and prolonged hospital stay (> 7 days) were analyzed in univariate and multivariate analysis through logistic regression. Results: During the study period, 65,454 patients were hospitalized for cellulitis. Factors associated with prolonged admission included admission to or consultation by a surgical service (OR 2.30, 95% CI 2.17–2.43) and dermatology consultation (OR 4.50,95% CI 3.92–5.17). Factors associated with mortality included surgical (OR 1.35, 95% CI 1.03–1.76) or infectious disease (OR 1.75, 95% CI 1.39–2.21) consultation. Conclusion: Misdiagnosis of cellulitis, suggested by the use of consulting services, may play a role in the morbidity and mortality of cellulitis patients.
Treatment of Nail Psoriasis with Intralesional Triamcinolone Acetonide Using a Needle-Free Jet Injector: A Prospective Trial
Authors: Nantel-Battista Melissa , Richer Vincent , Marcil Isabelle , Benohanian Antranik 
Published: October 2018

Background: Treating nail psoriasis is challenging. Corticosteroid matrix injection with needle is a conventional treatment but pain is often a limitation. Objective: Evaluate efficacy and safety of triamcinolone acetonide needle-free injection with the Med-Jet MBX in psoriatic fingernail. Methods: Seventeen patients were enrolled between January 2012 and January 2013. Four treatments sessions were scheduled every 4 ± 1 weeks. Clinical efficacy was evaluated according to Nail Psoriasis Severity Index (NAPSI) score of target nail differences before and after the treatment. Results: Mean baseline NAPSI score was 6.5 on an 8-point scale (95% confidence interval [CI] 5.652–7.348) and mean final NAPSI score was 2.8 on an 8-point scale (95% CI 1.859–3.741), demonstrating statistically significant treatment efficacy ( p=.0007). NAPSI score for target nail from baseline to end of treatment was decreased by 46.25%. Conclusion: Treatment with triamcinolone acetonide delivered by Med-Jet MBX is a safe, minimally painful and effective treatment for nail psoriasis.
Effect of Narrowband Ultraviolet B Therapy on Serum Vitamin D and Cathelicidin (LL-37) in Patients with Chronic Plaque Psoriasis
Authors: Al-Mutairi Nawaf , Shaaban Dalia 
Published: October 2018

Background: Narrowband ultraviolet B (NB-UVB) has been widely used in the treatment of psoriasis. It has been shown that vitamin D is a major regulator of the expression of human antimicrobial peptide cathelicidin LL-37, which has a critical role in inflammatory cascade in psoriasis. Objective: To evaluate the effect of NB-UVB therapy on serum levels of cathelicidin LL-37 and 25-hydroxyvitamin D [25(OH)D] in psoriasis patients. Methods: Ninety-three psoriasis patients and 50 controls were included in the study. For psoriasis patients, serum levels of 25(OH)D and cathelicidin LL-37 were estimated before and after NB-UVB therapy. Results: Before treatment, serum 25(OH)D levels were significantly lower in psoriasis patients (31.5 ± 14.41 nmol/L) compared to controls (53.5 ± 19.6 nmol/L), p = .015. In contrast, serum LL-37 was significantly higher in psoriasis patients (13.24 ± 3.2 ng/mL) than in controls (7.92 ± 5.33 ng/mL), p < .001. After NB-UVB treatment, there was a highly significant elevation of serum 25(OH)D to reach 56.85 ± 5.2 nmol/L ( p < .001) and further elevation of serum LL-37 to reach 29.4 ± 4.2 ( p = .02). Conclusions: The elevation of serum 25(OH)D and cathelicidin LL-37 could be an additional possible mechanism of action of NB-UVB therapy in the treatment of psoriasis.
Burning Mouth Syndrome
Authors: Lynde Carrie B. , Grushka Miriam , Walsh Scott R.A. 
Published: October 2018

Background: Burning mouth syndrome (BMS) is a burning or sore mouth in the absence of changes in the oral mucosa. It is often difficult to diagnose and treat. Numerous theories of the etiology have been suggested, including contact allergy. Objective: To determine the clinical utility of patch testing in patients with BMS. Methods: We retrospectively reviewed the charts of patients diagnosed with BMS who had patch testing performed between January 1, 2008, and July 31, 2012. Results: Of 142 consecutive patients with BMS, 132 consented to patch testing; 89 (67%) had allergic patch test reactions. Of the patients with positive results, 66 (74%) had results that were deemed to have possible relevance. The most common allergens detected were nickel sulfate 2.5%, dodecyl gallate 0.3%, octyl gallate 0.3%, fragrance mix 8%, benzoyl peroxide 1%, and cinnamic alcohol 1%. Conclusions: Our findings suggest that contact allergy may be an etiologic factor in some patients with BMS. Patch testing is a useful investigation for BMS patients.
Systematic Review of Interleukin-12, Interleukin-17, and Interleukin-23 Pathway Inhibitors for the Treatment of Moderate-to-Severe Chronic Plaque Psoriasis
Authors: Tausend William , Downing Christopher , Tyring Stephen 
Published: October 2018

Background: Monoclonal antibodies known as biologic agents specifically targeted against interleukin-12 (IL-12), interleukin-17A (IL-17), and interleukin-23 (IL-23) have been the focus of research for moderate-to-severe chronic plaque psoriasis in recent years. Objectives: To discuss the immune-mediated model of psoriasis and to summarize current knowledge of the clinical efficacy and safety of new biologic agents for moderate-to-severe chronic plaque psoriasis. Methods: The PubMed database was searched for relevant articles on ustekinumab, briakinumab, tildrakizumab (MK-322), guselkumab, secukinumab, ixekizumab, and brodalumab published between January 2005 and July 2013. Results: Fifty-five articles were identified. These studies suggest that the biologic agents specifically targeting IL-12, IL-17, and IL-23 are efficacious and safe in the treatment of moderate-to-severe psoriasis in adults. Conclusion: Current data from clinical trials suggest that biologic agents targeting IL-12, IL-17, and IL-23 are safe and efficacious drugs for use in moderate-to-severe chronic plaque psoriasis. Long-term data still need to be established.
Angiofibroma of the Vulva
Authors: Ahmadnia Hassan , Kamalati Ali , Dolati Mahmood , Rezayat Alireza Akhavan , Katebi Mehrdad 
Published: October 2018

Background: Cellular angiofibroma is a benign and rare tumor. It usually arises in middle-aged women and involves the vulva. Complete local excision of the tumor is the best cure, and, usually, there is no recurrence after surgery. Case Report: We describe a 20-year-old woman with a painless, growing vulvar mass who presented about 3 years ago. Her past medical history was negative for oral contraceptives, tobacco, and alcohol, and there were no similar lesions in her family history. A physical examination revealed two masses on the right and the left labia majora and similar lesions on the left axilla and both breasts. An uncomplicated simple resection of the vulvar masses was done in the operating room. There was no evidence of recurrence 12 months after surgery. Histopathologic examination revealed that the findings were consistent with the diagnosis of the cellular angiofibroma. Based on our knowledge, this patient is the youngest case of vulvar angiofibroma. The lesions were large and symmetrical (on both labia majora), although they differed in size. Extravulvar (breast and axilla) lesions were also noteworthy in this patient.