bluuebunny/crossref_metadata_2025_split huggingface dataset:
Open-Label Study of Valacyclovir 1.5 g Twice Daily for the Treatment of Uncomplicated Herpes Zoster in Immunocompetent Patients 18 Years of Age or Older
Authors: Madkan Vandana K. , Arora Anita , Babb-Tarbox Michelle , Aboutlabeti Sina , Tyring Stephen 
Published: March 2015

Background: Herpes zoster (shingles) is a common disease caused by a reactivation of the latent varicella-zoster virus (chickenpox), which resides in the dorsal root ganglia. Valacyclovir HCI, the L-valyl ester of acyclovir, is an antiviral drug that is used to accelerate the resolution of the herpes zoster rash and associated pain and reduce the duration of postherpetic neuralgia. Objective: To demonstrate the safety and efficacy of oral valacyclovir 1.5 g twice daily (bid) for the treatment of uncomplicated herpes zoster in immunocompetent patients over 18 years of age. The dosing schedule of bid versus three times daily is desirable for enhancing patient compliance and to subsequently reduce the incidence of viral resistance. Methods: One treatment group of 125 patients was administered oral valacyclovir 1.5 g bid for 7 days. Administration of the first dose occurred within 72 hours after onset of rash. Patients were seen and assessed for cutaneous healing, zoster-associated pain (ZAP), and/or zoster-associated abnormal sensations (ZAAS). Patients under 50 years of age were followed for 4 weeks and patients 50 years of age and older were followed for a total of 24 weeks. Patients ≥ 50 years were also asked to record a daily diary on pain and abnormal sensations throughout the 24-week study period. Responses to resource use and quality of life questions were also collected. Safety was monitored by means of routine hematologic and biochemical assessments and reporting of adverse experiences. Results: Data from this study were compared with historical control groups both for three times daily antiviral therapy and for placebo. The results showed that twice-daily dosing was as safe and effective as three times daily dosing for the reduction of ZAP and ZAAS. Adverse-effect profiles were similar between the two different regimens, and both treatment groups showed better outcomes than the historical placebo group. Because it is standard of care to administer antivirals for the treatment of acute herpes zoster, a placebo-controlled trial is not possible, necessitating the use of historical controls. Conclusion: Oral valacyclovir 1.5 g bid is safe and effective for the treatment of uncomplicated herpes zoster in immunocompetent patients over 18 years of age. Twice-daily dosing may help increase patient compliance and therefore increase the effectiveness of treatment of the acute herpes zoster rash and the prevention of ZAP.
Hidradenitis Suppurativa in 64 Female Patients: Retrospective Study Comparing Oral Antibiotics and Antiandrogen Therapy
Authors: Kraft John N. , Searles Gordon E. 
Published: March 2015

Background: Hidradenitis suppurativa (HS) is a recurrent disease confined to apocrine gland-bearing areas causing painful, deep-seated lesions and draining sinus tracts. Uniformly effective therapy is lacking. Improvements in current medical management strategies are needed. Objective: We sought to determine the success rate for a variety of treatments in our female HS patients and whether androgen-related tests can predict a response to antiandrogen therapy. As HS has been linked to a hyperandrogen state, we sought to determine if it is also associated with polycystic ovary syndrome (PCOS). Methods: A retrospective chart review was performed examining hormonal profiles and the response to a variety of treatments in female patients with HS. Results: Sixty-four female HS patients were identified (mean age 33 years). Antiandrogen therapy was superior to oral antibiotic therapy (55% vs 26%) based on a two-sample, two-sided, t-test statistic (p < .04). The prevalence of PCOS among our study patients in whom androgen markers were available was 8 of 21 (38.1%), and even if taken over all study patients, not necessarily investigated for PCOS, the prevalence was 8 of 64 (12.5%). This reflects a greater than expected prevalence among all women (10%). Conclusion: As a proof-of-concept study, despite limitations inherent in a retrospective chart review, there is sufficient signal to suggest that a hormonal manipulation approach to therapy should be considered in all women presenting with HS. Female patients presenting with HS should prompt investigations for underlying PCOS and insulin resistance.
Time to Diagnosis of Melanoma: Same Trend in Different Continents
Authors: Blum Andreas , Ingvar Christian , Avramidis Michelle , von Kannen Andreas , Menzies Scott W. , Olsson Håkan , Rezze Gisele G. , Wennberg Ann-Marie , Westerhoff Karin 
Published: March 2015

Background: Patients and physicians both play an important role in the diagnosis of malignant melanoma. Objective: The purpose of this study was to assess important factors of delay in diagnosis at different centers and on three continents. Methods: Between October 2001 and October 2002, patients with histologically confirmed invasive melanoma were included in the study and given an established questionnaire. Recorded patients and tumor characteristics included age, sex, anatomic location, Breslow thickness, patients' awareness of the lesion and time with suspicion, and physicians' time (delay) before the operation. Results: The study included 985 patients (486 males, 499 females): 253 from Germany, 464 from Sweden, 58 from Brazil, and 210 from Australia. More females detected their lesions by themselves. The change to a darker color (21 %) and enlargement of the area of the lesion (19%) were the major signs. The highest knowledge among patients that early detection may improve the outcome was found in Sweden and Australia. At each center, the media (newspaper, magazine, radio, and television) provided the best sources of information about melanoma. Twenty to 33% of all physicians initially consulted missed the melanoma diagnosis, independent of their specialty. Conclusions: There are still factors for the delay in melanoma diagnosis in different countries and continents, but the differences are rather small. The results should be included in planning prevention campaigns in this specific field and in the education of medical students, physicians of all specialties, and other health professionals.
Open-Label, Single-Center, Safety Dose Escalation Trial of Alefacept for the Treatment of Moderate to Severe Chronic Plaque Psoriasis
Authors: Moul Danielle K. , Routhouska Shannon B. , Korman Neil J. 
Published: March 2015

Background: Alefacept (Amevive) is a fully human LFA-3/IgG1 fusion protein with a dual mechanism of action inhibiting T-cell activation and selectively reducing memory T cells. Alefacept is currently approved as a 12-week course of weekly 15 mg intramuscular (IM) injections for the treatment of adults with moderate to severe chronic plaque psoriasis. In clinical trials using the currently approved dosing regimen, 33% and 57% of patients achieved a 75% or greater or 50% or greater reduction in Psoriasis Area and Severity Index score (PASI 75 and PASI 50), respectively, after one course of alefacept. Objective: To evaluate the tolerability and efficacy of alefacept 15 mg IM weekly for 6 weeks followed by alefacept 30 mg IM weekly for 6 weeks. Design: Open-label, single-center, dose escalation study of alefacept. Patients: Adult patients with chronic plaque psoriasis involving a minimum body surface area of 10% and with a minimum PASI of 12. Intervention: Patients were treated with alefacept 15 mg IM for 6 weeks followed by alefacept 30 mg IM for an additional 6 weeks; doses were held for CD4 counts < 200 cells/mm3 or evidence of a clinically significant infection. Main Outcome Measure: Efficacy was evaluated by PASI and Physician Global Assessment (PGA) at baseline, week 7, and 2, 6, 12, and 24 weeks post-treatment. Results: Sixteen patients were enrolled; at 6 weeks post-treatment, the PASI mean reduction was 39%, with continued improvement to 46% at 12 weeks post-treatment. The PASI 90, PASI 75, and PASI 50 responses at 12 weeks post-treatment were 6% (1 of 16), 13% (2 of 16), and 38% (6 of 16), respectively; 12% (2 of 16) of patients achieved a PGA of clear to almost clear at 12 weeks post-treatment. The overall PASI 75 and PASI 50 responses were 19% (3 of 16) and 38% (6 of 16), respectively. Conclusion: The treatment regimen of alefacept 15 mg IM for 6 weeks followed by alefacept 30 mg IM for 6 weeks was well tolerated by our patients. There was no increased incidence of infections when patients were treated with alefacept 30 mg compared with the 15 mg dose. The increased dose of alefacept 30 mg for the last 6 weeks of a 12-week course did not appear to yield a higher efficacy rate compared with historical controls.
Overexpression of p27KIP1 in Seborrheic Keratosis
Authors: Bruecks Andrea K. , Kalia Sunil , Trotter Martin J. 
Published: March 2015

Background: The pathogenesis of seborrheic keratosis (SK) is not well understood. SKs are slow growing, but the details of cell cycle control in these lesions are not known. We hypothesized that cyclin-dependent kinase inhibitors would be strongly expressed in SKs and that the proliferation rate would be low. Objectives: To quantify the expression of Ki67, p16INK4a, p21WAF1, and p27KIP1 in SK. Methods: We assessed acanthotic SKs ( n = 10) and irritated SKs ( n = 10) for Ki67, p16INK4a, p21WAF1, and p27KIP1 expression using immunohistochemistry. Results: For nonirritated acanthotic pattern SKs, the Ki67 index was 3.4% (range 0.6–6.5%), confirming a low proliferation rate. The p16INK4A index was 6.0% (range 0–16%), and the p21WAF1 index was 4.8% (range 0–25%). p27KIP1 was strongly and diffusely expressed in all SKs, with a labeling index of 78% (range 75–85%). The labeling indices were similar in irritated SK lesions with a slightly increased proliferation rate and corresponding decrease in p27KIP1 expression. Conclusions: We conclude that in SKs, strong expression of the cyclin-dependent kinase inhibitor p27KIP1 appears to be a major mechanism controlling keratinocyte proliferation.
Alefacept is Safe and Efficacious in the Treatment of Palmar Plantar Pustulosis
Authors: Guenther Lyn C. 
Published: March 2015

Background: Alefacept blocks T-cell activation and induces apoptosis of memory T cells. It improves psoriasis vulgaris and may induce prolonged remissions. Experience with alefacept in palmar plantar pustulosis (PPP) is limited. Objective: The objective of the study was to observe the effectiveness and safety of alefacept in the treatment of PPP. Methods: Alefacept was administered weekly for 16 weeks by intramuscular (IM) injection of 15 mg to 15 patients with moderate to very severe PPP. Patients were followed for an additional 12 weeks. Results: Four weeks after 16 weeks of treatment, there was a 49.6% reduction in the Palmoplantar Pustulosis Psoriasis Area and Severity Index (PPPASI) and a 38.6% and a 64.5% reduction in total and fresh pustules, respectively. Eight weeks after dosing, 53.3% achieved PPPASI 50, 26.7% achieved PPPASI 75, and one patient was clear. The mean percent reduction in total pustules and fresh pustules was 46.1% and 61.2%, respectively; 73% had no pain, 53% had no itching, and 80% had no functional impairment. The palms responded better than the soles. Conclusions: This pilot showed that 16 weeks of once-weekly alefacept 15 mg IM was safe, led to improvement in PPP in all 15 treated patients, and induced a remission in one patient. Larger double-blind studies are warranted.
Association between Proliferative Scars and In-Stent Restenosis
Authors: Ozdol Cagdas , Turhan Sibel , Tulunay Cansin , Altin A. Timucin , Atmaca Yusuf , Candemir Basar , Erol Cetin 
Published: March 2015

Background: Keloid and hypertrophic scars are two types of proliferative scars at sites of cutaneous injury that form as a result of an abnormal wound-healing process. Proliferative scar formation after skin injury and restenosis after coronary stenting have common features. The aim of this study was to investigate the association of proliferative scars with coronary stent restenosis. Methods: Patients with previous open heart surgery with median sternotomy who had coronary stenting after the surgery and were admitted for control angiography were included in the study. The patients were divided into two groups according to the presence or absence of proliferative scars. The primary end point was the incidence of angiographic restenosis in patient groups. Results: The study group consisted of 80 patients (64 men; mean age 64 ± 9 years). Twenty-three patients (29%) have a proliferative scar. In general, two groups were comparable with regard to baseline lipid profiles, demographics, and cardiovascular risk factors. Restenosis was significantly more prevalent in patients with proliferative scars than with controls ( p = .04). By multivariate logistic regression analysis, stent length (odds ratio [OR] 1.12, p = .005), diabetes (OR 3.3, p = .03), and proliferative scar (OR 4.2, p = .02) independently predicted in-stent restenosis. Conclusion: The findings of this study suggest that patients with proliferative scars may have a higher risk of in-stent restenosis.
Secondary Syphilis Presenting as Annular Lichenoid Plaques on the Scrotum
Authors: Narang Tarun , De Dipankar , Dogra Sunil , Kanwar Amrinder Jit , Saikia Uma Nahar 
Published: March 2015

Background: Secondary syphilis can have protean clinical manifestations and can present with unusual lesions, which may go unrecognized. Methods: We report two cases of secondary syphilis with annular lichenoid plaques on the scrotum associated with generalized lymphadenopathy, fever, and malaise. Results and conclusions: The serology revealed a reactive Venereal Disease Research Laboratory test and a positive Treponema pallidum hemagglutination assay. The human immunodeficiency virus (HIV) serology was nonreactive. The lesions cleared with a single dose of benzathine penicillin, 2.4 million units, given intramuscularly. The presentations of syphilis, often described as “x201C;the great imitator,” can be varied and atypical. Increased clinical vigilance and awareness of the varied modes of presentation are needed to prevent missing this highly treatable, potentially serious condition.
Unusual Presentations of Molluscum Contagiosum
Authors: Al-Mutairi Nawaf 
Published: March 2015

Background: Molluscum contagiosum is a common viral skin infection. Unusual presentations of this condition among immunocompetent individuals have rarely been reported. Objective: To highlight atypical clinical presentations of molluscum contagiosum in immunocompetent individuals. Methods and Results: An analysis of all cases of molluscum contagiosum with unusual presentation seen over a period of 2 years in the Farwaniya Department of Dermatology was conducted. Four patients (two males, two females), aged 13 to 35 years, with atypical molluscum contagiosum were encountered. Diagnosis was confirmed histopathologically. All of them were healthy, immunocompetent individuals without any underlying skin condition, except one who had preceding hand dermatitis. Clinical clues that could be helpful in making a diagnosis of molluscum contagiosum with an atypical presentation were looked for. Conclusion: A histopathologic examination may be necessary to make the diagnosis.
Incidence and Mortality Data from Cutaneous Melanoma in Trentino: Registry-Based Study
Authors: Boi Sebastiana , Cristofolini Mario , Micciolo Rocco , Polla Enzo , Piffer Silvano , Gentilini Maria 
Published: March 2015

Background: The province of Trento has been the target of health campaigns for early diagnosis of cutaneous melanoma for 30 years. Objective: To evaluate incidence and mortality data of skin melanoma in the province from January 1992 to December 2001. Methods: The study is based on the provincial skin cancer registry and the regional mortality registry. Standardized incidence and mortality rates were computed, and time trends were evaluated. Incidence rates were modeled using Poisson regression. Results: Five hundred fifty-four melanomas were diagnosed (226 in males and 328 in females). No period effect was revealed. Incidence rates in females were about 1.24 times those in males. No significant trend in mortality rates was observed. Conclusion: We examined incidence and mortality data of cutaneous melanoma during a 10-year period and failed to find any significant trend. It seems we have reached a plateau after many years of continuous, intensive health campaigns.
Naftifine: A Review
Authors: Gupta Aditya K. , Ryder Jennifer E. , Cooper Elizabeth A. 
Published: March 2015

Background: Naftifine is a topical allylamine that is effective and safe in the management of superficial dermatomycoses. Naftifine is fungicidal in vitro against a broad spectrum of dermatophyte fungi and provides good activity against Candida and Aspergillus species. It is also effective against gram-negative and gram-positive bacteria. Objective: To provide a review of the pharmacologic properties and clinical efficacy of topical naftifine preparations. Methods: A review of the medical literature was performed using PubMed (1965–2006) using the search term “naftifine.” All available English-language articles discussing the pharmacology and clinical use of naftifine were reviewed for the article. Results: Naftifine causes interruption of fungal ergosterol synthesis and accumulation of squalene in fungal organisms. Naftifine also has demonstrated anti-inflammatory properties such as a reduction in superoxide production and a reduction in polymorphonuclear leukocyte chemotaxis/endothelial adhesion. Naftifine has shown good efficacy and safety for a variety of conditions and is a useful treatment that provides both antifungal action and relief of inflammatory signs and symptoms. Few adverse events have been noted with naftifine use, the most frequent being mild and transient burning, stinging, or itching in the application area. Conclusion: Naftifine remains a reliable multifunctional agent for a variety of superficial infections.
Dermatologic Manifestations of Underlying Infectious Disease among Illicit Injection-Drug Users
Authors: Blondin David , Crawford Richard I. , Kerr Thomas , Zhang Ruth , Tyndall Mark W. , Montaner Julio S. , Wood Evan 
Published: March 2015

Background: Drug use patterns and serious bloodborne infections commonly have dermatologic manifestations among illicit injection-drug users (IDUs). Objective: To assess how self-reported skin conditions of IDUs may correlate with underlying infectious diseases after adjustment for drug use patterns. Methods: Prospective analysis of factors associated with self-reports of skin rashes, cellulitis, oral lesions, and lymphadenopathy obtained from 1,065 IDUs enrolled in a large cohort study. Variables potentially associated with each outcome were evaluated using multivariate generalized estimating equations. Results: In multivariate analyses, drug use patterns were associated with cellulitis, whereas human immunodeficiency virus (HIV) infection and hepatitis C (HCV) were not. HCV infection was independently associated with skin rashes (odds ratio [OR] 1.85; 95% Cl 1.17–2.94). HIV infection was independently associated with lymphadenopathy (OR 2.00; 95% CI 1.52–2.63), skin rash (OR 2.12; 95% CI 1.57–2.86), and oral lesions (OR 14.95; 95% CI 9.41–23.76). Conclusions: Self-reports of IDUs, which could easily be obtained as part of a functional inquiry in a clinical setting, correlate with specific drug use patterns and underlying bloodborne infections.
Hand Rejuvenation Using Intense Pulsed Light
Authors: Goldman Alberto , Prati Clarissa , Rossato Flávia 
Published: March 2015

Background: The aging of the hands is typically characterized by wrinkles, skin thinning, and solar lentigines. The search for effective treatments has led to the use of laser and intense pulsed light (IPL) technologies. Objective: To assess the effectiveness of an IPL device for the improvement of dyspigmentation and overall skin quality on the dorsa of the hands. Methods: Twenty-three patients with sun damage and solar lentigines on the dorsal hands were treated with four IPL sessions at 3- to 4-week intervals. Prior to treatment, photographs were taken and informed consent was obtained. Pre- and post-treatment photography and investigator clinical assessment and patient questionnaires were collected for data analysis. Results: After four treatment sessions, good to excellent results in the improvement in solar lentigines and skin quality were assessed by investigators in 100% of the cases and in 86.94% (20 of 23 subjects) by patient self-assessments. No significant side effects were observed. Conclusion: IPL is an effective and safe treatment option to improve solar lentigines and skin texture for hand rejuvenation.
Onycholysis Associated with Capecitabine in Patients with Breast Cancer
Authors: Hogeling Marcia , Howard Jessica , Kanigsberg Nordau , Finkelstein Harvey 
Published: March 2015

Background: Onycholysis, which is separation of the nail plate from the nail bed at its distal and lateral attachments, can cause pain and impair function and is a well-known side effect of traditional chemotherapeutic agents. Objectives: We present two cases of onycholysis associated with capecitabine in women with advanced breast cancer, who were initially referred for evaluation of onychomycosis and review the literature on capecitabine. Conclusion: Owing to the increased frequency of use of capecitabine for different cancers, physicians should be aware of this side effect.
Measurement of Utility in Nonmelanoma Skin Cancer
Authors: Lear William , Akeroyd Jennifer Ellen , Mittmann Nicole , Murray Christian 
Published: March 2015

Background: Quality of life is an important variable in assessing the impact of a condition on patients. The current literature shows a minimal effect of nonmelanoma skin cancer (NMSC) on patients' quality of life. This contrasts with our own experience. Given this disparity, we sought to perform an additional study in this area. Past studies have used multiattribute methods to assess quality of life. In contrast, the present study uses health utility methods, which rate a patient's quality of life from 0 to 1, with 1 representing perfect health. Methods: Forty-one patients were guided through two standardized scenarios using a standard gamble process with a trained interviewer. Health utility scores were determined for both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) using various NMSC treatment modalities. Results: All patients had health utility scores of 0.99 or higher. The standard gamble method showed no statistically significant differences in health utility scores for any treatment scenario for BCC or SCC using raw data comparisons. However, a modified standard gamble approach showed significantly higher health utility scores for both BCC and SCC treated using surgical modalities. Conclusion: Using the standard gamble health utility method in patients with BCC or SCC, it appears that these tumors have a minimal impact on the quality of life in the present study group. However, the results may simply reflect the poor sensitivity of the standard gamble health utility method to accurately assess quality of life changes in patients with NMSC. A modification of the standard gamble method did show that patients with NMSC associated surgical treatments with a better health outcome. New outcome measures need to be devised to accurately assess the toll of NMSC on patients.