bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nodular Amyloidosis: Case Report and Literature Review
Authors: Kakani Rajesh S. , Goldstein Amy E. , Meisher Irina , Hoffman Cindy 
Published: July 2017

Background: Amyloidosis refers to a group of depositional diseases that are classified into two main types: systemic and localized. Large nodules of localized cutaneous amyloidosis of the nasal ala and surrounding skin are rare and the treatment is often unsatisfactory. Objective: We report a case of rapidly enlarging, localized, nodular cutaneous amyloidosis of the nose and the surrounding skin with a brief review of the current literature regarding treatment of this rare disease. Conclusion: Nodular amyloidosis can be treated successfully with cold steel excision in combination with carbon dioxide laser. Close followup of these patients is warranted, as nodular amyloidosis may be the precursor to systemic amyloidosis.
Measurement Properties of Skindex-16: A Brief Quality-of-Life Measure for Patients with Skin Diseases
Authors: Chren Mary-Margaret , Lasek Rebecca J. , Sahay Anju P. , Sands Laura P. 
Published: July 2017

Background: An accurate, sensitive, but brief quality-of-life outcomes measure is needed for studies of dermatologic care. Objective: To construct a single-page version of Skindex (a dermatologic quality-of-life instrument) that would have two new features compared with the current 29-item version: (1) fewer items to which a majority of patients choose the same response, and (2) measurement of bother rather than frequency of patient experiences. Methods: Random samples of patients waiting for dermatology appointments in clinics of Veterans Affairs hospitals and in private dermatology practices completed questionnaires; 692 patients responded to the parent instrument and 541 additional patients responded to the brief version. Reproducibility, internal consistency reliability, validity, and responsiveness of the brief version of Skindex were determined. Results: For 16 items of the current 29-item version (55%), more than 50% of patients responded “Never.” After an explicit process of item analysis and elimination, a single-page 16-item version was composed that asks patients about bother from their experiences; responses are reported as three scales, Symptoms, Emotions, and Functioning. For 6 items of the 16-item version (38%), more than 50% of patients responded “Never.” Scale scores were reproducible after 72 hours ( r = 0.88–0.90) and were internally reliable (Cronbach's a = 0.86–0.93). The instrument demonstrated both content and construct validity: Most patients' responses to an open-ended question about their skin disease was addressed by the items; patients with inflammatory dermatoses had higher scores than those with isolated lesions; and in an exploratory principal axes factor analysis with an oblique rotation, 74% of the common variance was explained by three factors that correlated with the a priori scales. Mean scale scores stayed the same or changed in the expected direction in patients who reported that their skin was the same or had improved. Conclusion: This brief single-page version of Skindex accurately and sensitively measures how much patients are bothered by their skin conditions.
Postirradiation Multiple Minute Digitate Porokeratosis
Authors: Pujol Ramon M. , Perez–Losada Eugenia , Matias–Guiu Xavier , Fuentes Josefina , Alonso Carmen M. , Alomar Agustin , Craven–Bartle Jordi 
Published: July 2017

Background: Development of multiple minute digitate hyperkeratoses (MMDH) after irradiation has been reported previously. The keratotic lesions in these cases were confined within the irradiation field, and histopathological examination disclosed a focal column of parakeratosis (cornoid lamella) arising from an epidermis devoid of granular layer. Objective: We describe a 78-year-old woman who developed multiple, discrete, tiny, filiform, keratotic papules on the anterior aspect of the right chest wall, 13 months after postmastectomy cobalt irradiation therapy for mammary infiltrating ductal carcinoma. Conclusion: Postirradiation MMDH represents a peculiar radiation-induced disorder that we believe should be distinguished from other cases of MMDH and included within the spectrum of porokeratosis.
Using the Internet to Assess and Teach Medical Students in Dermatology
Authors: Hong Chih-Ho , McLean David , Shapiro Jerry , Lui Harvey 
Published: July 2017

Background and Objectives: We wish to develop and evaluate a user-friendly online interactive teaching and examination model as an adjunct to traditional bedside teaching of medical students during a clinical rotation in dermatology. Methods: Following completion of an online examination, senior medical students at the University of British Columbia ( n = 178) were asked to complete an online survey to evaluate their acceptance of this new method. The online examination model was evaluated through students' responses to the questionnaire-based evaluation they were asked to complete following their examination. Responses were evaluated on a standardized 5-point scale. Results: A high response rate was achieved (98.9%). Overall, 93% of senior medical students felt that the Internet was a useful and effective way to administer a dermatology examination. Most (90%) preferred the online examination to a traditional paper-and-pencil examination and the majority (88%) felt that the quality of digital images presented was sufficient to make an accurate diagnosis. In addition, students strongly supported the further development of teaching resources on the web and would use these resources in learning dermatology (93%). Conclusions: The development of an online interactive examination tool for dermatology is technically feasible with current technology. Senior medical students are not only accepting of this new technology but also prefer it to more traditional formats and indicate enthusiasm for the development of further online teaching resources in dermatology.
Free Flap Coverage of Pyoderma Gangrenosum Leg Ulcers
Authors: Classen Dale A. , Thomson Chris 
Published: July 2017

Background: Pyoderma gangrenosum is a necrotizing skin disorder of unknown cause. Treatment of pyoderma gangrenosum usually entails medical treatments. Surgical treatment is generally not successful. Objective: Two patients with pyoderma gangrenosum of their lower extremities are presented. The application and utility of microvascular free flap coverage of their ulcers is discussed. Results: Both patients achieved successful healing with microvascular free flaps. Conclusion: Microvascular free flap coverage may be a surgical treatment option for selected patients with pyoderma gangrenosum.
Experimental Keloid Scar Models: A Review of Methodological Issues
Authors: Hillmer M. P. , MacLeod S. M. 
Published: July 2017

Background: Keloid scars are benign fibrous proliferations in the dermis that arise after dermal trauma. The scars are raised in appearance and extend beyond the boundaries of the original wound. Scarring in predisposed individuals is out of proportion to the severity of the inciting wound. Current treatments sometimes yield early benefit but scars often resume exuberant growth. The pathophysiology of keloid scars is still poorly understood. In order for new treatments to be developed, the mechanisms leading to the formation of keloid scars must be further elucidated. The search for improved experimental models is of critical importance because such models have an important role to play in both the study of keloid formation and in the development of new therapies. Objective: The objective of this article is to introduce the reader to the experimental models available for studying keloid scars and to outline the advantages and limitations of animal and tissue culture models. Conclusion: Both models may help to elucidate the pathways of keloid formation and promote development and testing of therapies. Tissue culture is better suited to studies of pathogenesis, whereas the animal models are more suitable for therapeutic testing.
Barrier and Antibacterial Properties of 2-Octyl Cyanoacrylate-Derived Wound Treatment Films
Authors: Mertz Patricia M. , Davis Stephen C. , Cazzaniga Alejandro L. , Drosou Anna , Eaglstein William H. 
Published: July 2017

Background: Besides enhancing healing, an ideal dressing should prevent invasion of pathogens and control the number of bacteria already present in the wounds. Objective: To evaluate the barrier and antimicrobial properties of a cyanoacrylate-based bandage (LAB) against Staphylococcus aureus or Pseudomonas aeruginosa on partial thickness wounds in swines. Methods: Barrier study: Bacteria were inoculated over test materials (LAB, standard bandage, air-exposed) that were placed over wounds. The bacteria from wounds were quantitated at 24, 48, and 72 hours postinoculation. Antimicrobial study: Wounds inoculated with bacteria were covered with LAB, standard bandage, or hydrocolloid bandage or left air-exposed. The bacteria recovered from wounds were quantitated at 24 and 72 hours after treatment. Results: Barrier study: No bacteria were recovered from LAB-treated wounds. Antimicrobial study: LAB reduced the number of inoculated bacteria in comparison to all other groups. Conclusion: LAB is effective in protecting wounds from external bacterial invasion and reducing bacterial contamination.
In-vitro Analysis for Microbial Barrier Properties of 2-Octyl Cyanoacrylate-Derived Wound Treatment Films
Authors: Narang Upvan , Mainwaring Lawrence , Spath Gina , Barefoot Joe 
Published: July 2017

Background: In recent years, 2-octyl cyanoacrylate monomer has been formulated for various wound care products that have been approved by the Food and Drug Administration (FDA). Purpose: To evaluate the in vitro effectiveness of 2-octyl cyanoacrylate formulation-based films as barriers to various pathogens, including bacteria, fungi, and yeast. Methods: The barrier properties of the cyanoacrylate films prepared by the following two methods were tested: (1) prepolymerized film and (2) in situ polymerized film. The upper surface of films was inoculated such that the microorganisms would have to penetrate the film to colonize the media beneath. Nine different organisms were used. Plates were observed for growth at two, four, and seven days after inoculation. Results: No growth was observed in any test, with the exception of prepolymerized film challenged with Pseudomonas aeruginosa. The pattern of growth observed suggests that the bacteria colonized the medium by traveling around and not through the film. Conclusions: 2-Octyl cyanoacrylate-based films are excellent microbial barriers.
Keloid Morphea and Nodular Scleroderma: Two Distinct Clinical Variants of Scleroderma?
Authors: Rencic Adrienne , Brinster Nooshin Ketabchi , Nousari Carlos H. 
Published: July 2017

Background: For nearly a century, the terms “keloid morphea” and “nodular scleroderma” have been used interchangeably without defined clinical or histologic criteria. Objective: To define the conditions “keloid morphea” and “nodular scleroderma” by correlating the clinical and histologic features. Methods: We retrospectively identified six patients with keloidal lesions and nodules from 70 consecutive patients with scleroderma seen in the dermatology clinic. The clinical presentation and histopathological findings were reviewed. Results: Six of 70 patients with scleroderma (45 systemic and 25 morphea) exhibited keloidal or nodular lesions. All these patients had systemic sclerosis. Clinically one patient (case 1) had nodules; five (cases 2–6) had keloids. The nodular lesions had histologic findings consistent with keloid, while the keloidal plaques were variably keloids or morphea histopathologically. There was no correlation between the clinical morphology and the histologic findings, except for cases 5 and 6. These patients were African–American, with a family history of keloids and typical keloids clinically and histologically that developed from sites with normal skin. Conclusion: Keloid morphea and nodular scleroderma are clinical terms that describe keloidal and nodular lesions in patients most commonly with scleroderma. The clinicopathologic association is variable. Based on a review of the English literature and our series of six patients, we identified two clinical variants; (1) keloidal or nodular lesions arising from sclerodermatous skin with histologic findings of keloid or scleroderma, (2) typical keloids clinically and histologically, arising in normal skin in patients with a family history of keloids. Awareness of these entities is important for proper diagnosis of the cutaneous lesions and for recognizing that the cutaneous findings may be a sign of systemic sclerosis.
A Randomized, Double-Blind, Multicenter, Parallel Group Study to Compare Relative Efficacies of the Topical Gels 3% Erythromycin/5% Benzoyl Peroxide and 0.025% Tretinoin/Erythromycin 4% in the Treatment of Moderate Acne Vulgaris of the Face
Authors: Gupta Aditya K. , Lynde Charles W. , Kunynetz Rod A. W. , Amin Smita , Choi Ken Lee , Goldstein Eric 
Published: July 2017

Background: Combination treatments for acne vulgaris, such as Benzamycin® (3% erythromycin/5% benzoyl peroxide) and Stievamycin® (0.025% tretinoin/erythromycin 4%), reduce bacterial growth, which contributes to the inflammatory lesions typical of adolescent acne, and also decrease the epidermal cell compaction which may form the characteristic noninflammatory comedone. Both agents contain erythromycin to reduce the growth of Propionibacterium acnes in skin. Benzoyl peroxide has antibiotic activity as well as anticomedogenic properties. Tretinoin may increase the turnover of epidermal cells and loosen the cells compacted to form comedones. A combination preparation containing the two antibiotics may reduce the development of resistance; the combination preparation containing tretinoin and erythromycin will have an antibiotic effect as well as acting on differentiation. Patients and Methods: This multicenter, randomized, double-blind, parallel group study compared the effectiveness of 3% erythromycin/5% benzoyl peroxide and 0.025% tretinoin/erythromycin 4%, each applied twice daily in patients with moderate acne vulgaris. Overall physician and patient ratings of severity of acne symptoms were performed at baseline and at weeks 2, 4, 8, and 12. Results: At baseline the two treatment groups had similar disease severity. The number of papules, pustules, and comedones was reduced in both treatment groups at week 12, and the reductions were not significantly different between the two comparators. Global physician rating of improvement was significantly higher in the 3 % erythromycin/5% benzoyl peroxide group compared with the 0.025% tretinoin/ erythromycin 4% group; however, there was no significant difference in global patient ratings between the two treatment groups. An aggregate score was produced, for both physician rating and patient rating, by adding up individual symptom severity ratings. Compared with 0.025% tretinoin/erythromycin 4%, 3% erythromycin/5% benzoyl peroxide provided significantly greater reduction in both physician- and patient-rated severity of acne symptoms; there was a significant difference between the two groups as early as week 2. The 3% erythromycin/5% benzoyl peroxide demonstrated significantly greater reduction of erythema and scaling, as evaluated by the study physician, compared with tretinoin 0.025%/erythromycin 4%. Patients judged 3% erythromycin/ 5% benzoyl peroxide to have a significantly greater effect on redness, dryness, oiliness, and burning. Conclusion: In moderate acne vulgaris, 3% erythromycin/5% benzoyl peroxide may provide a greater beneficial effect than 0.025% tretinoin/erythromycin 4%.
Encephalocraniocutaneous Lipomatosis
Authors: Gawel Julita , Schwartz Robert A. , Józwiak Sergiusz 
Published: July 2017

Background: Encephalocraniocutaneous lipomatosis (ECCL) is a relatively new, nonhereditary, but congenital, neurocutaneous syndrome with unilateral cutaneous tumors and ipsilateral ophthalmologic and neurologic malformations. The syndrome is rare, with only 25 cases reported since first communication in 1970. The primary clinical features noted for almost all cases are as follows: (1) unilateral porencephalic cysts with cortical atrophy, (2) ipsilateral lipomatous hamartoma of the scalp, eyelids, and outer globe of the eye, (3) cranial asymmetry, (4) marked developmental delay and mental retardation, (5) seizures, and (6) spasticity of the contralateral limbs. Objective: We discuss underlying pathophysiology, diagnostic difficulties, differential diagnosis, and therapeutic possibilities of the syndrome. Conclusions: The syndrome seems to be more frequent than it was thought. ECCL may remain unrecognized, as some patients may not represent the full clinical spectrum of the disease. Periodic neurologic and cardiologic assessment with echocardiography and electrocardiography should be carried out in all patients with ECCL because of a possible progressive disease course.
Alopecia Mucinosa: Report of a Case and Review
Authors: Anderson Bryan E. , Mackley Christine L. , Helm Klaus F. 
Published: July 2017

Background: Alopecia mucinosa has been shown to be associated with many benign and malignant conditions. It can be seen in childhood but is seen more commonly in adulthood. Alopecia mucinosa is generally felt to occur in three settings: a primary idiopathic form, a form associated with malignancy, and a form secondary to inflammatory conditions. The histologic hallmark is the accumulation of mucin in the follicular epithelium, called follicular mucinosis. Therapy for alopecia mucinosa remains problematic. Objective: We present a representative case of alopecia mucinosa and discuss the etiology, histology, epidemiology, treatment, and prognosis. Conclusion: We report a case of idiopathic alopecia mucinosa that responded to minocycline with a complete remission and we review the literature on alopecia mucinosa.
Thrombospondin-1 and Cutaneous Melanoma
Authors: Trotter M. J. , Colwell R. , Tron V. A. 
Published: July 2017

Background: Thrombospondins (TSPs) are recognized as important glycoproteins that regulate a wide variety of cell functions and interactions. TSPs in malignant tumors can both enhance and inhibit tumor progression, invasion, and metastasis, depending on cell type, stromal interactions, and microenvironment. These proteins are potential targets for anticancer therapy. Objective: The aim of our article is to review the role of thrombospondin-1 (TSP1) in cutaneous melanoma. Conclusions: TSP1 expression is variable in melanoma cell lines and tumors. Similar to findings in other human cancers, expression of TSP1 by melanoma cells usually inhibits tumor progression via the antiangiogenic effect of TSP1. Conversely, stromal TSP1 overexpression in melanoma is a poor prognostic factor associated with decreased survival. Understanding the interactions of TSP1 with other melanoma- and matrix-associated proteins should provide new prognostic indices and possible therapeutic targets for melanoma treatment.
The Importance of Skin Disease as Assessed by “Willingness-To-Pay”
Authors: Parks Lauren , Balkrishnan Rajesh , Hamel-Gariépy Line , Feldman Steven R. 
Published: July 2017

Background: To achieve optimal resource allocation in health care, it is necessary to value competing resource uses according to the benefit derived from those uses. Skin disease makes as great an impact as other serious medical conditions when assessed by effects on health-related quality of life. Objective: To confirm the high impact of skin disease by comparing patients' willingness to pay (WTP) to be cured or relieved from symptoms of skin and nonskin conditions. Methods: We searched the published literature on WTP to compare the impact of dermatologic conditions with the impact of other medical conditions. A total of 46 articles were identified of which 10 included information on willingness to pay for cure reported on a monthly basis. Results: WTP for skin diseases fell in the range of $125–260/month and was comparable or higher than all but one of the other identified conditions. Conclusion: Willingness to pay for relief from skin diseases is comparable to that for relief of other serious medical conditions. Skin diseases are associated with a significant adverse impact on patients' lives.
Valacyclovir in the Treatment of Herpes Simplex, Herpes Zoster, and other Viral Infections
Authors: Wu Jashin J. , Brentjens Mathijs H. , Torres Gisela , Yeung–Yue Kimberly , Lee Patricia , Tyring Stephen K. 
Published: July 2017

Background: Genital herpes and herpes labialis are prevalent, physically and pychologically painful, and often disabling. Herpes zoster is often very painful and may result in months or years of postherpetic neuralgia (PHN). Over the past two decades, the treatment of these conditions has been transformed by guanosine nucleoside antivirals such as valacyclovir (Valtrex®), a highly bioavailable prodrug of acyclovir (Zovirax®), and famciclovir (Famvir®), a highly bioavailable prodrug of penciclovir (Denavir®). Objective: We describe the pharmacology, pharmacokinetics, and clinical efficacy of valacyclovir for the treatment of herpes simplex, herpes zoster, and other viral infections. Valacyclovir is also compared with acyclovir and famciclovir. Methods: All published literature containing the word “valacyclovir” was reviewed and summarized. Results: Valacyclovir is the only oral antiviral agent approved for therapy of herpes labialis, the only antiviral drug approved for a 3-day course in the episodic treatment of recurrent genital herpes, as well as the only antiviral drug approved for once daily dosing for suppressive therapy. In herpes zoster, valacyclovir is more effective than acyclovir and equally effective as famciclovir at hastening the healing of zoster-associated pain and PHN. Conclusion: Valacyclovir is safe and effective in the therapy of patients with herpes simplex and herpes zoster and may be useful in other viral infections.
Generalized Cutis Laxa Associated with Heavy Chain Deposition Disease
Authors: Tan Stephen , Pon Kucy , Bargman Joanne , Ghazarian Danny 
Published: July 2017

Background: Cutis laxa is a heterogeneous group of inherited and acquired disorders characterized clinically by loose skin and histologically by altered elastic tissue. Heavy chain deposition disease is a very rare monoclonal immunoglobulin disorder, distinct from multiple myeloma, in which there is production and deposition of defective immunoglobulin heavy chains without light chain deposition. Objective: We describe a case of acquired cutis laxa associated with heavy chain deposition disease. Results: A 50-year-old male presented with acute renal failure, IgG4 heavy chain deposition in the kidneys, and no evidence of multiple myeloma. Four years later, he developed generalized acquired cutis laxa, emphysema, and a peripheral polyneuropathy. On pathology, there was destruction of elastic fibers within the dermis. Conclusion: This case describes a previously unreported association between acquired cutis laxa and heavy chain deposition disease. Antécédents: Cutis laxa est un groupe hétérogène de troubles héréditaires et acquis qui se caractérise cliniquement par un relâchement de la peau et histologiquement par l'altération du tissu élastique. La maladie des chaînes lourdes est un trouble très rare de l'immunoglobuline monoclonale, différent du myélome multiple où il y a production et dépôt de chaînes lourdes, sans chaînes légères, de l'immunoglobuline déficiente. Objectif: Description d'un cas non conventionnel de cutis laxa acquise associée à une maladie des chaînes légères. Méthodes: Description du cas et aperçu de cutis laxa. Observation: Un homme de 50 ans présente une insuffisance rénale, des dépêts dans les reins de chaînes lourdes IgG4 et aucune preuve de myélome multiple. Quatre ans plus tard, il développe une cutis laxa généralisée acquise, un emphysème et une Polyneuropathie périphérique. La pathologie a montré une destruction des fibres élastiques du derme. Conclusion: Ce cas décrit une association jamais établie auparavant entre cutis laxa et une maladie des chaînes lourdes.