bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herpetic Folliculitis
Authors: Al-Dhafiri Shehab A. M. , Molinari Raynald 
Published: July 2017

Background: Although herpetic skin infection is very common, herpetic folliculitis is infrequently reported in the literature. It has varied presentations, some of which are clinically atypical requiring histopathological confirmation of follicular involvement. Objective: We describe an otherwise healthy young adult male with extensive herpetic sycosis of the beard area, which is a variant of herpetic folliculitis. The diagnosis was confirmed by typical herpetic cytopathic changes in Tzanck smear and positive viral culture for HSV-1. Method: This article includes a case report and a literature review of herpetic (simplex and varicella/zoster) folliculitis. Conclusions: More cases of herpetic folliculitis should be reported to improve our understanding of this disease entity. Physicians should consider herpetic or other viral etiology in patients with folliculitis even if they were healthy, especially if they show resistance to antibacterial and antifungal therapy.
Keratoelastoidosis Marginalis
Authors: Mengesha Yebabe M. , Kayal John D. , Swerlick Robert A. 
Published: July 2017

Background: Keratoelastoidosis marginalis is a rare disease that is a variant of solar elastosis. Long-term ultraviolet radiation exposure and chronic trauma secondary to manual labor are considered to be inciting factors. Objective: To outline the clinical and histological features of this disorder. Methods: We report two cases and review the literature. Results: Both patients had persistence of their disease despite multiple topical treatment regimens. Conclusion: Keratoelastoidosis marginalis is a chronic and progressive disease that is difficult to treat. The differential includes focal acral hyperkeratosis and acrokeratoelastoidosis.
A Listing of Skin Conditions Exhibiting the Koebner and Pseudo-Koebner Phenomena with Eliciting Stimuli
Authors: Rubin Adam I. , Stiller Matthew J. 
Published: July 2017

Background: The Koebner phenomenon was first described in 1872. It occurs after a variety of traumatic insults. New examples of koebnerization are reported each decade. Objective: We have compiled, for the first time in the dermatologic literature, an extensive list of the cutaneous diseases reported to demonstrate koebnerization, correlated in each case with the precise source of trauma. Cutaneous diseases reported to show a pseudo-Koebner phenomenon and the corresponding mechanism of trauma are also detailed. Methods: A search and review of the English language literature on MEDLINE was made to identify cutaneous diseases exhibiting the Koebner phenomenon and the correlated mechanism of trauma. Results: Results of our efforts are cataloged in table format. Conclusion: We present an extensive list of cutaneous diseases reported to exhibit the Koebner and pseudo-Koebner phenomena, correlating each entry with the mechanism of trauma.
A Clinical Evaluation of Tazarotene 0.1% Gel, with and without a High- or Mid-High-Potency Corticosteroid, in Patients with Stable Plaque Psoriasis
Authors: Green Lawrence , Sadoff Wendy 
Published: July 2017

Background: Several clinical trials have established the benefit of using a topical corticosteroid in conjunction with tazarotene gel in the treatment of plaque psoriasis. However, there is little information comparing the relative benefits of different corticosteroids, or different formulations of corticosteroids, when used adjunctively with tazarotene. Objective: This study was designed to compare the clinical benefits achieved with each of six commonly prescribed high- or mid-high-potency corticosteroid creams and ointments applied in conjunction with tazarotene 0.1% gel in the treatment of patients with stable plaque psoriasis. Methods: A 12-week, multicenter, investigator-masked, randomized, parallel-group study was performed with more than 200 patients who were randomly assigned to regimens of tazarotene 0.1% gel alone, tazarotene plus a high-potency topical corticosteroid (fluocinonide 0.05% ointment, mometasone furoate 0.1% ointment, or diflorasone diacetate 0.05% ointment), or tazarotene plus a mid-high-potency topical corticosteroid (betamethasone dipropionate 0.05% cream, fluticasone propionate 0.005% ointment, or diflorasone diacetate 0.05% cream). All medications were to be applied once daily: corticosteroids in the morning, tazarotene gel in the evening. At assessment visits, physicians made an overall evaluation of the patient's psoriasis and graded global improvement, plaque elevation, scaling, erythema, and pruritus. Patients also rated their treatment in terms of efficacy, tolerability, and satisfaction. Results: The best-performing steroid was betamethasone dipropionate 0.05% cream (a mid-high-potency steroid), followed by mometasone furoate 0.1% ointment (a high-potency steroid) and diflorasone diacetate 0.05% ointment (a high-potency steroid). Maximum improvements were achieved within 8 weeks. The best-tolerated regimen was tazarotene plus mometasone furoate 0.1% ointment and the optimal balance between efficacy and tolerability was achieved with this regimen. Conclusion: Some steroids are considerably more effective than others in optimizing the efficacy and tolerability of tazarotene therapy. With a suitable combination regimen, the duration of initial therapy (before maintenance therapy is started) need not be prolonged.
Chronic Pruritus Associated with Helicobacter Pylori
Authors: Kandyil Roshini , Satya Nadia S. , Swerlick Robert A. 
Published: July 2017

Background: Helicobacter pylori is an established cause of gastritis and has been implicated in extradigestive diseases. Objective: To investigate the role of H. pylori in patients with unexplained refractory pruritus. Methods: Ten patients with severe pruritus unresponsive to conventional therapy were evaluated for active H. pylori infection by H. pylori serology followed by either esophagogastroduodenoscopy (EGD) or urea breath test. Of the 10 patients, 8 were found to have active infection. All 10 received anti- H. pylori antibiotic therapy and were reevaluated for relief of pruritus. Results: Of 8 patients with active H. pylori infection, 87.5% (7/8) had some type of pruritus relief after triple therapy. Of these, 62.5% (5/8) had complete relief and 25% (2/8) had temporary relief of pruritus. The remaining 12.5% (1/8) did not respond. Two control patients without active H. pylori infection had no relief of pruritus with therapy. Conclusions: We have identified a population of patients with refractory pruritus and active H. pylori infection whose pruritus resolved after eradication of H. pylori.
Transformation in Mycosis Fungoides: The Role of Methotrexate
Authors: Abd-El-Baki Jasmin , Demierre Marie-France , Li Ning , Foss Francine M. 
Published: July 2017

Background: Large cell transformation in patients with mycosis fungoides (MF) has been well reported in the literature. Although the risk factors have not been clearly elucidated, advanced stage seems to be associated with a higher incidence of transformation. Because MF is a rare disorder, little is known about the influence of other factors such as immunosuppressive therapy in the occurrence of transformation. Objective: We questioned the role of methotrexate (MTX) in the transformation of MF to large cell lymphoma (LCL). Methods: We identified all patients with MF who were registered in our cutaneous lymphoma database. Transformation was defined by the presence of large cells exceeding 25% of the infiltrate in at least one skin biopsy. In one patient, we followed the histologic, immunophenotypic, and genotypic changes taking place as transformation occurred. Results: A total of 134 patients with MF were identified. Of 21 patients who received MTX, 3 transformed, and of the 113 patients in the non-MTX group, only 2 transformed. The incidence of transformation in the patients who received MTX was significantly higher than in those who did not receive the drug (14.3% vs. 1.8%; p = 0.03). This significance was maintained, even after controlling for stage and sex. For one patient who transformed, we demonstrated an identical dominant T-cell clone in all skin specimens, including the large cell lymphoma. Conclusion: Our results demonstrate a significant association between MTX exposure and transformation to LCL in patients with MF. In light of the small sample size, short followup of patients, and the inherent tendency of mycosis fungoides to transform, the role for MTX in transformation is unproven and needs to be confirmed in a multicenter study.
Acute Generalized Exanthematous Pustulosis Induced by Oral Fluconazole
Authors: Alsadhan A. , Taher M. , Krol A. 
Published: July 2017

Background: Acute generalized exanthematous pustulosis (AGEP) is a generalized, nonfollicular, pustular eruption of the skin associated with fever and leukocytosis. The cause of AGEP has mainly been attributed to drugs. Objective: We report a unique case of AGEP in a 75-year-old male caused by oral fluconazole. We include clinical as well as histological illustrations of our case. Conclusion: Based on a current literature search using the MEDLINE electronic database, this is the first reported case of AGEP arising from use of oral fluconazole. The clinical presentation, clinical course, and histology are consistent with prior reports of AGEP resulting from other drugs. AGEP should be considered a possible complication of oral fluconazole treatment.
Hepatic Safety of Itraconazole
Authors: Gupta Aditya K. , Chwetzoff Elisabeth , Del Rosso James , Baran Robert 
Published: July 2017

Background: As the use of the newer oral antifungal agents for the treatment of superficial fungal infections becomes more widespread, the issue of safety surrounding their use is becoming an increasingly important consideration. Itraconazole is effective and well tolerated, with most side effects being minor and reversible. The most common adverse events are gastrointestinal upset, headache, and transient skin reaction. There have also been rare reports of hepatitis. Objective: To assess the hepatic safety of pulse and continuous itraconazole in the treatment of onychomycosis. Methods: An analysis was performed on all itraconazole clinical trials sponsored by Janssen Research Foundation in the treatment of onychomycosis, where there was an assessment of laboratory safety. A review of the published literature was also undertaken to assess the hepatic safety of itraconazole in common practice. Results: The data indicate that itraconazole pulse treatment is safe, with no significant differences in the number of code 4 abnormalities (baseline value is in the normal range and at least two values, or the last testing in the observation period, exceed twice the upper limit of normal) in the liver function parameters studied: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, and total bilirubin. The incidence of all the code 4 abnormalities was below 2%. In the literature there are reports of symptomatic hepatitis with itraconazole continuous therapy but no published report of symptomatic hepatotoxicity using the pulse regimen. Conclusions: Itraconazole pulse therapy for onychomycosis appears to be safe, especially from the perspective of potential liver damage. In the itraconazole package insert liver function tests are recommended for patients receiving continuous itraconazole for periods of time exceeding 1 month. There is no such monitoring requirement for the pulse regimen unless the patient has a history of underlying hepatic disease, the liver function tests are abnormal at baseline, or at any time that there is the development of signs or symptoms suggestive of liver dysfunction.
Granuloma Gluteale Adultorum Associated with Use of Topical Benzocaine Preparations: Case Report and Literature Review
Authors: Dytoc Marlene T. , Fiorillo Loretta , Liao Janice , Krol Alfons L. 
Published: July 2017

Background: Granuloma gluteale infantum is a skin disorder of controversial etiology manifested clinically by oval reddish-purple granulomatous nodules on the gluteal surfaces and groin areas of infants. Similar granulomas are noted in adults and the elderly and are referred to as granuloma gluteale adultorum and diaper area granuloma of the aged, respectively. Occlusion from diapers, paper napkins, plastic pants, detergents, starch, powder, halogenated steroids, candidal infection, and urine and feces are postulated as possible etiologies. Objective: We report a case of a 40-year-old woman presenting with a 3-year history of multiple, painful, closely set, red-purple, oval, smooth, firm papules and nodules in the genitocrural area. The development of the lesions was associated with prolonged use of topical benzocaine. Histology of the lesions was consistent with granuloma gluteale infantum. Gram stain and culture of representative tissue did not demonstrate bacterial or fungal organisms. The lesions significantly improved with discontinuation of topical benzocaine. Patch testing of skin to determine allergic contact hypersensitivity to benzocaine was negative. Conclusion: We propose that topical benzocaine preparations may play a role in the pathogenesis of granuloma gluteale adultorum, independent of contact sensitization to benzocaine.
Rare Presentations of Basal Cell Carcinoma
Authors: Nouri Keyvan , Romanelli Paolo , Trent Jennifer T. , Javid Roya , Jimenez Gloria 
Published: July 2017

Background: Even though basal cell carcinomas (BCC) are the most common skin cancers in the world, they rarely appear in the African–American, Hispanic, and Asian populations. BCCs most commonly present on the head and neck of elderly, light-skinned individuals who have received an excessive amount of sun exposure. However, it has been hypothesized that the development of BCCs in unusual populations is a result of an alteration in tumor surveillance or an impairment in cellular immunity. Objective: We present two cases of BCC, one in an Asian woman and one in an African–American woman. Neither of these patients had any history of genodermatoses or were immunocompromised. Conclusion: BCCs can occur in Asian and African–American patients. Clinicians should include the diagnosis of BCC in their differential for these patients despite their rare presentations.
The Genes and Genetics of Malignant Melanoma
Authors: Gibbs Peter , Brady Benjamin M. R. , Robinson William A. 
Published: July 2017

Background: Population-based studies have identified several clinical variables associated with an increased risk of developing cutaneous melanoma that include phenotype, amount of and response to sun exposure, and family history. However, these observations are of limited relevance to clinical practice as the risk associated with each factor is individually modest and the characteristics of these variables lack precision when applied to a particular individual. Objective: To review the literature regarding recent advances made in the understanding of the genes and genetics of clinical variables associated with an increased risk of melanoma. Conclusion: Variants of the MC1R (melanocortin-1 receptor) have been identified as major determinants of high-risk phenotypes, such as red hair and pale skin, and the ability to tan in response to UV exposure. Several studies also suggest that such variants may increase melanoma risk independent of their contribution to phenotype. A strong genetic basis for both nevus density and size has been demonstrated and the link between nevi and the development of MM has become better defined. Finally, germline defects in several genes involved in cell cycle regulation, namely, p16 and CDK4, have been demonstrated in many familial melanoma kindreds. This progress has introduced the prospect of genetic testing as a means of identifying a limited number of high-risk individuals who can be targeted with regular screening and education regarding UV exposure and skin self-examination. Ultimately, through rational genetic therapy targeted to correcting the underlying molecular defect, altering the natural history of melanoma development may be possible.
HLA Haplotypes and Class II Molecular Alleles in Argentinian Patients with Pemphigus Vulgaris
Authors: Glorio Roberto , Costa Graciela Rodriguez , Haas Roxana , Gruber Mijail , Fainboim Leonardo , Woscoff Alberto 
Published: July 2017

Background: Pemphigus is a group of chronic blistering autoimmune diseases of which pemphigus vulgaris (PV) is the more frequent clinical form. The association of PV with the HLA serotypes suggests that there is a genetic predisposition to the disease. Objectives: To determine the frequency of class I and class II HLA antigens and the allelic variants of the class II HLA antigens, DR and DQ, in patients with PV and to determine the relative risk. Methods: An observational, prospective, transverse, and controlled study carried out between 1995 and 1999. Forty-seven patients with a diagnosis of PV and a control sampling of 199 unselected individuals from the same ethnic group were included. The HLA alleles were determined by polymerase chain reaction. Results: No significant associations were detected between HLA A, B, or C and our patients. The DR and DQ molecular alleles positively associated with PV were two different haplotypes: DRβ1* 0402/DQβ1* 0302 and DRβ1* 1401/DQβ1* 0503. Conclusions: In patients with the haplotype DRβ1* 0402/DQβ1* 0302 the affectation of 10%–30% of the corporal surface prevailed (ACS). In patients with DRβ1* 1401/DRQβ1* 0503, involvement of <10% of the ACS prevailed.
A 10-Year Prospective Study of Patients with Skin Cancer
Authors: Czarnecki D. , Sutton Tina , Czarnecki C. , Culjak G. 
Published: July 2017

Background and Objective: To determine the incidence of new skin cancer formation in people who have had a nonmelanoma skin cancer (NMSC) removed. Methods: A prospective study of Australian outpatients with histologically confirmed nonmelanoma skin cancer (NMSC). Results: Four hundred eighty-one patients were entered in the study and 300 were followed for at least 10 years. Another skin cancer developed in 67.8% and multiple skin cancers (three or more) in 51.8%. A logistical regression analysis found that the main risk factors for new skin cancer formation were male sex and if the patient had multiple skin cancers. A squamous cell carcinoma (SCC) developed in 36% during the study and a melanoma in 4.7% of men and 2.1% of women. Men who had a NMSC were 8 times more likely than the general population to develop a melanoma while women with NMSC were 4 times more likely. Three patients died of metastatic SCC and one of metastatic melanoma during the followup period. A multivariate analysis showed that multiple skin cancer formation was the main risk factor for SCC or melanoma formation. Conclusion: Patients with NMSC require careful followup as they have an increased risk of new cancer formation. Those with multiple skin cancer merit particularly careful followup as all develop another NMSC within 10 years and have a significantly increased risk of developing SCC or melanoma.
The Changing Face of Canadian Dermatology
Authors: Marcoux Danielle , Gratton David 
Published: July 2017

Background: In 1986, Cosmair Canada, agent of the L'Oréal Group, sponsored a survey among Canadian dermatologists to measure the perceptions, attitudes, expectations, and needs of dermatologists regarding cosmetology. Fifteen years later, a new survey among Canadian dermatologists, again sponsored by L'Oréal, tries to capture the evolution and new trends. Objectives: This survey tries to capture the perceptions, attitudes, and expectations of Canadian dermatologists regarding cosmetology. Methods: A questionnaire was sent to 394 members of the Canadian Dermatology Association; 99 responded (25%). The questionnaire, had 21 questions regarding cosmetology, future trends in Canadian dermatology, and how dermatologists acquire the information required for their practice. Results: More than ever, dermatologists are asked to deal with maintaining healthy, youthful skin. Cosmetology is a greater part of everyday practice. Laser and cosmetic dermatology will become more important in the future. Conclusions: Dermatologists are asked to provide information on the maintenance of healthy, young-looking skin and feel they need more information relating to cosmetology.
Nonpsoriatic Uses of Calcipotriol
Authors: Gupta Aditya K. , Browne Melanie , Bluhm Robyn 
Published: July 2017

Background: Calcipotriol is a synthetic vitamin D3 analog that binds to vitamin D receptors in epidermal cells. In vitro studies have shown that calcipotriol stimulates terminal cell differentiation and has antiproliferative effects. In vivo, calcipotriol has been shown to reduce the number of cycling epidermal cells. Calcipotriol also has less effect on calcium metabolism than calcitriol, which is the natural, bioactive, 1,25-dihydroxyvitamin D3. Objective: These properties make calcipotriol an ideal candidate for the topical treatment of hyperproliferative skin disorders. While it has been approved for topical use in psoriasis, its potential for use in other dermatological disorders has not yet been fully investigated. Conclusion: This survey of the literature suggests that calcipotriol may show promise in the treatment of other conditions involving abnormal keratinization and hyperproliferation of epidermal cells. While some of these disorders are rare, and therefore difficult to study, further study into the nonpsoriatic uses of calcipotriol may be rewarding.
NSAIDs in Dermatologic Therapy: Review and Preview
Authors: Friedman Edward S. , LaNatra Nicole , Stiller Matthew J. 
Published: July 2017

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been an important therapy in the treatment of a large number of cutaneous pathologies for more than three decades. Objective: In this retrospective review, we document the use of NSAIDs in more than 15 common and uncommon dermatoses, including acne, psoriasis, sunburn, erythema nodosum, cryoglobulinemia, Sweet's syndrome, systemic mastocytosis, as well as urticarial, livedoid, and nodular vasculitis. NSAIDs act mainly by inhibiting prostaglandin synthesis by the cyclooxygenase (COX) pathway. Conclusion: Recent studies link prostaglandin to cutaneous carcinogenesis, thus expanding the dermatologic use of NSAIDs. They may be effective in the treatment and prevention of non-melanoma skin cancer, and specific COX-2 inhibitors promise safer, broader, long-term use of these pharmacologically innovative drugs.
Long-Term Safety of Spironolactone in Acne: Results of an 8-Year Followup Study
Authors: Shaw James C. , White Lucile E. 
Published: July 2017

Background: Spironolactone has been used for over 20 years as an antiandrogen in the treatment of acne and hirsutism. No long-term studies of the safety of spironolactone used in this manner have been published. We present a study of the long-term safety and tolerance of spironolactone in 91 women with acne who were followed for up to 8 years. Methods: A survey questionnaire was sent to 210 patients, and a comparison chart review of all patients to whom the survey was sent was made. Results: Ninety-one completed surveys were analyzed, comprising 506 person-years of followup and 200 person-years of spironolactone exposure. Mean treatment length was 28.5 months (range = 0.5–122 months). During the 8-year followup period, there were no cases of serious illness attributable to spironolactone use. Side effects were present in 59% and resulted in cessation of the drug in 15%. Diuretic effect and menstrual irregularities were the most common adverse effects. Conclusions: After 200 person-years of exposure to spironolactone and 506 person-years of followup over 8 years, no serious illnesses thought to be attributed to spironolactone were reported. The long-term use of spironolactone in the treatment of acne in women appears to be safe. Side effects, however, are common, although not usually a cause for stopping the drug.