bluuebunny/crossref_metadata_2025_split huggingface dataset:
5-Year Review of a Unique Multidisciplinary Nonmelanoma Skin Cancer Clinic
Authors: Culleton Shaelyn , Breen Dale , Assaad Dalal , Zhang Liying , Balogh Judith , Tsao May , Kamra Juhu , Czarnota Greg , Antonyshyn Oleh , Fialkov Jeffery , Barnes Elizabeth 
Published: March 2015

Background: A multidisciplinary nonmelanoma skin cancer (NMSC) clinic is held weekly at our center, where all new patients are jointly assessed by dermatology/dermatopathology, radiation oncology, and plastic surgery. A new patient database was established in 2004. The purpose of this study was to provide a preliminary report on the patients seen in the NMSC clinic and the treatment recommendations rendered. Methods: The new patient database was reviewed from January 2004 to December 2008, and patient demographics, tumor characteristics, and treatment recommendations were extracted. Cochran-Mantel-Harnszel (CMH) testing and chi-square analysis were used to detect any associations or relationships between variables within the database. A p value of less than .05 was considered significant. Results: During the 5-year study period, 2,146 new patients were seen in the NMSC clinic. The majority of patients presented with basal cell carcinoma (64%) or squamous cell carcinoma (22%), with a median tumor size of 1 to 2 cm (range 0 to #x003E; 9 cm). Tumors were located in the head and neck region (80%), extremities (14%), and torso (6%). Previous treatment included biopsy only (62%), surgery (20%), electrodesiccation and curettage (11%), topical imiquimod (3%), and radiotherapy (1%). Treatment recommendations included surgery (55%) (with either simple excision [31%] or excision with margin control under frozen-section guidance [24%]), radiotherapy (19%), topical imiquimod (10%), observation (7%), and electrodesiccation and curettage (4%). Conclusions: The NMSC clinic at our center sees a high volume of patients who benefit from the multidisciplinary assessment provided. Treatment recommendations were based on patient and disease characteristics as well as patient preference.
Psoriasis Treatment Patterns of Dermatologists in Northeast Ohio
Authors: Grozdev Ivan , Cao Lauren , Kavlick Kathleen , Brodell Robert T. , Mostow Eliot N. , Korman Neil J. 
Published: March 2015

Aim: To describe the psoriasis treatment patterns of community-based dermatologists in northeast Ohio. Materials and Methods: A prospective cross-sectional survey was performed among dermatologists in northeast Ohio. The survey was initiated by the Murdough Family Center for Psoriasis and members of LIFEDERMNET (Leaders Initiative For Excellence In Dermatology Network). A questionnaire was sent to all community-based dermatologists in northeast Ohio. Results: Forty-seven of 145 questionnaires were returned and analyzed. The annual mean number of psoriasis patients seen in the community-based dermatology practices was 250, representing approximately 4% of the total patients seen. Among the systemic treatment options for psoriasis, each of the following was used at least once to treat a patient with psoriasis in the previous year by the following percentage of community-based dermatology practices: methotrexate, 72%; acitretin, 68%; biologics, 66%; phototherapy, 55%; cyclosporine, 36%; and the excimer laser, 28%. Conclusion: Our findings demonstrate that dermatologists in northeast Ohio use both systemic and biologic agents for the treatment of patients with psoriasis.
Erythema Multiforme Major Associated with CMV Infection in an Immunocompetent Patient
Authors: Vitiello Magalys , Echeverria Begoña , Elgart George , Kerdel Francisco 
Published: March 2015

Background: Cytomegalovirus (CMV) infection usually remains asymptomatic in immunocompetent adults, and few cases of complicated disease in nonimmunosuppressed patients have been reported. Erythema multiforme (EM), an acute and self-limiting skin eruption characterized by a typical targetoid lesion that may also affect the mucosa, is a hypersensitivity reaction that usually occurs after herpes simplex virus infection or use of certain drugs and resolves without complications in healthy individuals. To our knowledge, CMV infection has been associated with EM in only six patients. Objective: We present a case of an EM caused by CMV infection in a 35-year-old nonimmunosuppressed patient who was successfully treated with ganciclovir. Conclusion: Our report, like other similar reports found in the literature, suggests that CMV can trigger EM in apparently healthy individuals. Intravenous ganciclovir appears to be a good treatment option in these cases.
Functions and Uses of Immunohistochemical Stains in Cutaneous Infiltrates of Hematopoietic Origin: A Review for the Practicing Dermatologist
Authors: Chisholm Cary , Cockerell Clay J. 
Published: March 2015

Background: Immunohistochemical stains, particularly those for cutaneous lymphomas, have similar-sounding names, which may lead to confusion among dermatologists who are not well versed in the terminology of the tools used for pathologic diagnosis. Also aiding in this is the fact that some familiar stains are constantly investigated for novel utility in different tumors, and a plethora of new stains regularly emerge in the peer-reviewed literature. Objective: To review the major stains encountered in dermatopathologic reports for cutaneous lymphomas. A select number of other stains are reviewed that are either new and under investigation in several cutaneous processes or have a new use described in recent reports. Methods: The peer-reviewed literature was searched and analyzed for the accepted purposes of using these markers. Results: All pertinent findings for these immunostains are reported with the purpose of educating the dermatology community. Conclusion: This review serves as a reference to clarify potentially confusing immunohistochemical stains.
Multiple Symmetric Lipomatosis
Authors: da Silva Rodrigo Gomes , Bragança Renan Detoffol , Costa Carolina Ribeiro , de Melo Lorena Torres , Telles Rosa Weiss , Silva Luciana Costa 
Published: March 2015

Background: Multiple symmetric lipomatosis (MSL) is a relatively uncommon entity of unknown etiology characterized by symmetrically subcutaneous accumulation of nonencapsulated adipose tissue. Approximately 200 to 300 cases have been published. Objectives: The aims of this article are to report the case of a 58-year-old Brazilian patient with MSL and provide a comprehensive overview of the current concepts concerning this disease. Methods: Our search yielded 28 articles on MSL, including case reports and reviews of the literature. Results: MSL predominantly affects Mediterranean males with a history of chronic alcohol abuse. It is usually asymptomatic and may be associated with diabetes mellitus, hyperlipidemia, hyperuricemia, macrocytic anemia, and oral cancer. Surgical resection is the best treatment option. Conclusion: The case reported is a classic presentation of MSL; however, it is particularly uncommon owing to the association with immune thrombocytopenic purpura. This association has been described only once in the medical literature.
Bullous Scabies Simulating Pemphigoid
Authors: Stan T. Roxana , Piaserico Stefano , Bordignon Matteo , Salmaso Roberto , Zattra Edoardo , Alaibac Mauro 
Published: March 2015

Background: Scabies is a contagious infestation affecting subjects of all ages, races, and social conditions. Objective: We report a case of a 79-year-old man who developed a bullous pemphigoid-like eruption. He presented to our unit 4 months after the onset of symptoms. An autoimmune bullous disease was suspected. Direct immunofluorescence on a skin specimen and anti-desmoglein 1, anti-desmoglein 3, and anti-bullous pemphigoid antigen 180 were negative. Surprisingly, the histology of a skin lesion demonstrated the presence of scabies, which was successfully treated with benzyl benzoate 20%. Conclusion: The diagnosis of bullous scabies should be considered for any bullous eruptions accompanied by papules and itching resistant to steroid treatment and with negative immunopathologic findings.
Annular Elastolytic Giant Cell Granuloma Associated with Temporal Arteritis Leading to Blindness
Authors: Shoimer Ilya , Wismer Judy 
Published: March 2015

Background: Annular elastolytic giant cell granuloma (AEGCG) is a rare granulomatous disorder characterized by giant cells in the dermis phagocytosing damaged elastin fragments. Objective: We report a case of a 71-year-old man presenting with erythematous plaques in predominantly sun-exposed areas. Method: A diagnosis of AEGCG was made based on the clinical and histologic picture, and treatment with systemic steroids was initiated. However, while tapering the steroid dose, the patient developed a radiating headache that progressed to temporal arteritis and eventual blindness in the right eye. Conclusion: There have been only two previous case reports presenting an association between AEGCG and temporal arteritis. This report explores AEGCG and its possible relationship to temporal arteritis along with possible treatment regimens cited in the current literature.
Unusual Case of Proximal Calciphylaxis without Renal Failure
Authors: Stanciu Monica , Gagné-Henley Angélique , Thérien Geneviève 
Published: March 2015

Background: Calciphylaxis is a rare syndrome of vascular calcification with subsequent cutaneous and tissue necrosis. It usually manifests as a complication of end-stage renal failure, affecting 1 to 4% of long-term dialysis patients. Very exceptionally, it can occur without chronic renal failure. Objective: The goal of this study was to discuss an exceptional case of extensive calciphylaxis in the absence of chronic renal failure and its successful management. Methods: We present a case of a 31-year-old woman with extensive proximal, ulcerated calciphylaxis without associated chronic renal failure. Our patient had quite a few risk factors associated with the pathogenesis of calciphylaxis, such as obesity, malnutrition, and a transient episode of acute renal failure. Results: She was successfully treated with sodium thiosulfate, extensive wound débridement (more than 30% total body surface), and subsequent skin grafts. The patient has miraculously survived this often fatal condition. Conclusion: Calciphylaxis can occur even in the absence of chronic renal failure. This often fatal condition can be managed successfully with a combination of aggressive wound control and the fairly newly described sodium thiosulfate therapy.
Fibroblast Growth Factor-Binding Protein Facilitates the Growth and Migration of Skin-Derived Precursors
Authors: Huang Yong , Qi Shao-Hai , Shu Bin , Chen Lei , Xie Ju-Lin , Xu Ying-Bin , Liu Xu-Sheng 
Published: March 2015

Background: Fibroblast growth factors (FGFs) are important regulators of cell proliferation, migration, and differentiation during wound healing. FGF-binding protein (FGF-BP) plays a critical role in activating FGFs by releasing them from the extracellular matrix. Although previous studies have demonstrated a pivotal role for FGF-BP in wound healing and angiogenesis, little is known about the biologic effects of FGF-BP on skin stem cells that contribute to wound healing. Objective: To investigate the effects of FGF-BP on the growth and migration of skin-derived precursors (SKPs). Methods: FGF-BP was titrated to determine the optimal concentration that maximally stimulated cell proliferation. Cellular phenotype and telomerase activity were compared in the presence and absence of FGF-BP. The effect of FGF-BP on cell migration was observed by intravenously transplanting SKPs to adult mice. Results: Cell proliferation was maximally stimulated by FGF-BP at a concentration of 10 ng/mL without changing the intrinsic characteristics of SKPs. Low levels of telomerase activity were detected, and FGF-BP decreased the rate at which telomerase activity was downregulated. In vivo, FGF-BP remarkably enhanced the migration of SKPs to skin lesion sites. Conclusion: FGF-BP exerts a positive effect on the growth and migration of SKPs, suggesting a potential role for SKPs in wound healing.
Calcific Uremic Arteriolopathy Treated with Cinacalcet, Paricalcitol, and Autologous Growth Factors
Authors: Kakagia Despoina , Kriki Pelagia , Thodis Elias , Roumeliotis Athanasios , Vargemezis Vassilios 
Published: March 2015

Background: Calcific uremic arteriolopathy is an uncommon cutaneous ischemic necrotizing disease, most commonly associated with renal disease and hyperparathyroidism, bearing a high mortality rate. Objective and Method: A case of a 57-year-old female renal patient with hyperparathyroidism who was successfully treated with combined paricalcitol and cinacalcet systemically, while autologous growth factors were locally applied, is herein presented. Result and Conclusion: The combination of cinacalcet and paricalcitol is a reliable alternative to parathyroidectomy in patients with calcific uremic arteriolopathy and hyperparathyroidism. Meticulous débridement of necrotic tissues is essential and application of autologous growth factors promotes healing.
Likelihood of Dermatology Patients to Inquire about Sun Protection Measures during a Regular Clinic Visit
Authors: Jung Gordon W. , Senthilselvan Ambikaipakan , Salopek Thomas G. 
Published: March 2015

Background: Health information-seeking behavior refers to ways individuals acquire health information. Few studies demonstrate its association with skin cancer. Objectives: To determine the likelihood of patients to inquire about sun protection methods from dermatologists and whether such knowledge will affect their preventive behaviors. Methods: Over a 2-month period, 396 dermatology patients completed a survey assessing their sun awareness knowledge and inquiry about sun protection measures. Features associated with increased skin cancer risk were correlated with patients' inquiry about sun protection information and their future intentions to practice safe sun behavior. Results: One in seven patients (13.8%) inquired about sun protection measures. Patients with features known to be associated with increased skin cancer risk infrequently inquired about sun protection methods (4.5–23.8%). Post–physician counseling, patients with previous sun awareness education had a greater intention to use sunscreen routinely (41.4% vs 28.3%, p = .01), avoid the sun (31.2% vs 18.2%, p = .004), and wear sun-protective clothing (32.5% vs 23.2%., p = .05). Conclusion: Patients' desire for medical information from physicians does not translate efficiently into seeking sun awareness information from dermatologists. Dermatologists should play a greater proactive role in skin cancer prevention through initiation of regular personalized discussions on sun awareness issues.
Giant Dermoid Cyst of the Lower Limb: Presentation of a Rare Case
Authors: Iconomou Thomais , Zapantioti Polyxeni , Kakagia Despoina , Kyriopoulos Eugene , Papaliodi Eugene , Tsoutsos Dimosthenis 
Published: March 2015

Background: Dermoid cysts are unusual neoplasms that often present in childhood and are usually located in the head and neck region. Objective and Method: We describe a rare case of a giant dermoid cyst of congenital inclusion type located at the lower extremity of a young male. Preoperative imaging studies were performed for evaluation of the mass. Result: The cyst was surgically removed, and histopathologic examination confirmed the diagnosis. Conclusion: Dermoid cysts rarely appear in the lower extremity and must be included in the differential diagnosis of cystic lesions of the lower limb.
The Fusiform Skin Excision: One Recipe for Success
Authors: Kraft John , Murray Christian A. 
Published: March 2015

The fusiform skin excision is commonly performed by dermatologists. This brief review presents a stepwise approach to this procedure and discusses recent evidence related to dermatologic minor surgery. Les dermatologues pratiquent couramment l'excision fusiforme de la peau. Ce bref compte rendu présente une approche par étapes de cette intervention et une discussion sur les données récentes relatives aux petites chirurgies dermatologiques.
Techniques to Minimize the Pain of Injected Local Anesthetic
Authors: Baibergenova Akerke , Murray Christian A. 
Published: March 2015

The process of injecting local anesthetic still often remains the most uncomfortable part of dermatologic surgery for patients. This review discusses strategies that may be used to reduce this discomfort. Le processus d'injection d'un anesthésique local demeure souvent l'aspect le plus désagréable de la chirurgie dermatologique pour les patients. Ce compte rendu contient une discussion des stratégies que l'on peut utiliser pour réduire cet inconfort.
Methotrexate-Induced Cutaneous Ulcers in a Nonpsoriatic Patient: Case Report and Review of the Literature
Authors: Kurian Anil , Haber Richard 
Published: March 2015

Background: Methotrexate is a mainstay of treatment for autoimmune conditions such as rheumatoid arthritis and psoriasis. Methotrexate has numerous potential side effects and, in rare circumstances, can lead to cutaneous ulceration. Methotrexate can cause skin ulceration, and stopping this medication can lead to complete healing of the ulcerated lesion. Observations: A 67-year-old man with rheumatoid arthritis on long-term methotrexate therapy presented to hospital with ulcers on his hands, elbows, and lower extremities. He had no history of psoriasis. Shortly after admission, the patient was noted to have pancytopenia. A bone marrow biopsy showed a hypocellular marrow. Both the cutaneous ulcers and the hypocellular marrow were thought to be induced by methotrexate. The ulcerated areas were biopsied, and histopathology showed no evidence of vasculitis. After 1 month of rehabilitative skin care, the patient's ulcers healed almost completely and his bone marrow suppression recovered. Conclusion: We report the fifth case of methotrexate-induced cutaneous ulceration in a nonpsoriatic patient and review the literature on this unusual drug reaction. Methotrexate can induce cutaneous ulceration in nonpsoriatic patients and should be considered a potential cause of ulceration in patients treated with this antimitotic agent.
Multiple Cutaneous Granular Cell Tumors: Case Report of a 19-Year-Old African American Female
Authors: Henry Matthew , Perry Adam 
Published: March 2015

Background and Objective: This is a somewhat rare case of a 19-year-old African American female with multiple cutaneous granular cell tumors. Granular cell tumors are of neural origin, except in rare cases, and are considered benign, with a low incidence of malignancy. The clinical presentation varies greatly, but these tumors are most commonly painful and slow growing, with two-thirds occurring on the head and neck. Patients are most commonly in their second to fourth decades of life, two-thirds are black, and two-thirds are women. Granular cell tumors are diagnosed by the characteristic pathologic findings of polygonal cells with eosinophilic granular cytoplasm. Conclusion: These tumors are most commonly singular but can be multiple in 10 to 15% of patients. Older patient age, rapid growth or enlargement, and a history of local recurrence should raise concern for malignant behavior. The distribution and family history in this case are suggestive of possible mosaicism.
Phototherapy in Psoriasis: A Review of Mechanisms of Action
Authors: Wong Tami , Hsu Leon , Liao Wilson 
Published: March 2015

Background: Phototherapy is one of the most efficacious treatment options for psoriasis. New, emerging studies are beginning to define the biologic mechanisms by which phototherapy improves psoriasis. Methods: To provide an overview of the mechanisms thought to be responsible for the therapeutic effects of phototherapy, a review was performed on all relevant published studies in the Medline database from January 1, 1985, to August 15, 2011. Findings: Four categories of action were proposed in the literature to describe the effects of phototherapy in psoriasis: (1) alteration of the cytokine profile, (2) induction of apoptosis, (3) promotion of immunosuppression, and (4) all other mechanisms. Conclusions: Phototherapy acts through a combination of pathways to confer therapeutic benefits in psoriasis, and these different modalities may help explain its particular usefulness in treating this cutaneous disease.
Examining the Relationship between Alopecia Areata, Androgenetic Alopecia, and Emotional Intelligence
Authors: Monselise Assaf , Bar-On Reuven , Chan Lisa , Leibushor Naama , McElwee Kevin , Shapiro Jerry 
Published: March 2015

Background: Emotional stress has been associated with the development of alopecia areata (AA) and androgenetic alopecia (AGA). Emotional intelligence (EI), a component of general intelligence, is thought to govern the recognition, expression, and control of stress and other emotions. People with low EI are unable to adequately control stress in everyday life. Objective: To investigate EI differences between AA and AGA patients and a control population. Methods: Thirty-five AGA patients and 42 AA patients, with patchy ( n = 28), ophiasis ( n = 5), totalis ( n = 5), and universalis ( n = 4) distribution of hair loss, completed a 133-item Emotional Quotient-Inventory (EQ-I) psychometric assessment. Scores were compared between AA, AGA, and 77 control subjects obtained from the North American normative population sample on which the psychometric instrument was normed. Results: Statistically significant differences were found in EI between AA patients and controls with the EQ-I Stress Tolerance scale ( p = .005). AGA patients also differed significantly from the controls but to a lesser degree compared toAA patients. In overall EI, there were no apparent differences between AGA and AA patients. Conclusions: AA and AGA patients exhibit a mild depressive reaction to their condition, with AA patients demonstrating a significantly stronger deficiency in coping with stress than AGA patients. The data support a psychosomatic contribution to AA. Referral of patients for EI assessment and psychosocial counseling could help reduce stress.
Teaching Dermatology to Internal Medicine Residents: Needs Assessment Survey and Possible Directions
Authors: Drucker Aaron M. , Cavalcanti Rodrigo B. , Wong Brian M. , Walsh Scott R.A. 
Published: March 2015

Background: Internal medicine trainees receive limited teaching and training in dermatology and may feel inadequately prepared to assess and manage patients with dermatologic complaints. No study to date has assessed the needs of internal medicine trainees in Canada with regard to dermatology teaching. Objective: To determine internal medicine residents' comfort in assessing and managing dermatologic issues and their educational needs in dermatology. Methods: An electronic survey was conducted of first-, second-, and third-year internal medicine residents at the University of Toronto. Results: Fifty-four of 186 internal medicine trainees responded to our survey (response rate = 29%). Each respondent did not answer every question. Residents were generally uncomfortable or very uncomfortable assessing and managing dermatologic issues in the emergency department (40 of 47, 85%), ward or intensive care unit (39 of 47, 83%), and ambulatory clinic (40 of 47, 85%). Residents thought that various clinical and didactic dermatology exposures would be useful to their training as internists. Case-based teaching and ambulatory clinical rotations were felt to be particularly valuable. Additionally, 38 of 46 (83%) respondents wanted to learn how to perform punch biopsies. Conclusions: An effort should be made to increase the availability of relevant dermatology teaching and clinical exposures for internal medicine residents.