bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Validation of a Scale for Acne Scar Severity (SCAR-S) of the Face and Trunk
Authors: Tan Jerry K.L. , Tang Jing , Fung Karen , Gupta Aditya K. , Thomas D. Richard , Sapra Sheetal , Lynde Charles , Poulin Yves , Gulliver Wayne , Sebaldt Rolf J. 
Published: March 2015

Background: Scarring is an important component of overall acne severity, but there are no global scales for its evaluation inclusive of the face and trunk. Objective: Our objective was to develop a global scale for acne scar severity inclusive of the trunk and the face. Methods: A six-category global severity scale (SCAR-S) was developed for assessment of acne scarring at each of the face, chest, and back. We evaluated SCAR-S against acne severity and patient-reported scar severity. Results: Of 973 subjects, 73% reported acne scarring. Self-assessment of scarring was associated with facial SCAR-S and overall SCAR-S scores ( p < .001, r = .31 and .30, respectively). Acne scarring was observed at the face in 87%, the back in 51%, and the chest in 38%. Clinically relevant scarring (mild or greater) at each of these regions was 55%, 24%, and 14%, respectively. Acne severity correlated with SCAR-S ( p < .001) for the back ( r = .612), the chest ( r = .548), and the face ( r = .514). Acne duration correlated with patient-reported severity of scarring ( r = .244) and overall SCAR-S scores ( r = .152). Clinically relevant scarring increased with acne duration. Conclusion: SCAR-S is a practical, validated, global system for acne scar evaluation and is clinically relevant in overall severity grading of acne.
Acute Generalized Exanthematous Pustulosis in a Patient after Stem Cell Transplantation
Authors: Cetkovská Petra , Benáková Nina 
Published: March 2015

Background: A severe generalized pustular eruption occurred several months after allogeneic hematopoietic stem cell transplantation for multiple myeloma in a patient being treated with antibiotics for respiratory infection. Neither he nor his donor had a history of psoriasis. Methods: The patient was treated with drug withdrawal and administration of cyclosporine and methylprednisolone without improvement; later, acitretin and methylprednisolone were used successfully. The eruption slowly subsided, and therapy was discontinued. Four months later, the patient experienced a recurrent severe pustular eruption associated with fever and leukocytosis, and the same treatment was used successfully again. Results and Conclusion: The patient has not experienced relapses in the ensuing 3 years. Acute generalized exanthematous pustulosis is a rare cutaneous adverse reaction triggered most commonly by drugs with a tendency to resolve spontaneously. The surprisingly prolonged, refractory, and relapsing course of the eruption in our patient might be due to the immune alteration and the polypharmacologic therapy after stem cell transplantation. Antécédents: Une éruption pustulaire généralisée aiguë s'est produite chez un patient traité aux antibiotiques contre une infection respiratoire, plusieurs mois après une allogreffe de cellules souches hématopoïétiques pour myélome multiple. Ni le patient ni le donneur n'ont des antécédents de psoriasis.
Progressive Mucinous Histiocytosis: Importance of Electron Microscopy to Confirm Diagnosis
Authors: Hemmati Iman , McLeod W. Alastair , Crawford Richard I. 
Published: March 2015

Background: Progressive mucinous histiocytosis (PMH) is a benign, non-Langerhans cell histiocytosis with characteristic ultrastructural features that can be used for diagnosis. Once an important tool in dermatologic diagnosis, electron microscopy has been largely replaced by immunohistochemistry and immunofluorescence techniques today. However, electron microscopy occasionally still plays a crucial role in the diagnosis of dermatologic conditions. We report a case of PMH as an example of a dermatologic disorder that requires electron microscopy for its diagnosis. Methods: A 60-year-old woman presented to our clinic with a history of small, sharply demarcated, skin-colored papules ranging from 2 to 5 mm in diameter distributed over the arms, forearms, and dorsal hands. The results of light microscopy, immunohistochemical studies, and clinical examination were inconclusive. Another biopsy for electron microscopy showed the characteristic features of PMH. Conclusion: This case demonstrates that a dermatopathology service still needs to have access to electron microscopy for diagnostic purposes to successfully diagnose a small number of rare conditions.
Chemical Leukoderma Induced by Herbal Oils
Authors: Ghosh Sudip Kumar , Bandyopadhyay Debabrata 
Published: March 2015

Background: Chemical leukoderma (CL) may result from repeated exposure to specific chemical compounds such as industrial chemicals, cosmetics, and personal articles. The incidence of CL is reportedly increasing rapidly in developing countries. Objective: Two cases of chemical leukoderma arising out of use of herbal oils on the scalp and breasts are described. Conclusion: We emphasize the importance of a detailed history regarding possible exposure to chemical agents in patients with depigmented lesions, mainly in adults.
Anatomic Location of Basal Cell Carcinomas May Favor Certain Histologic Subtypes
Authors: Betti Roberto , Radaelli Giovanni , Bombonato Caterina , Crosti Carlo , Cerri Amilcare , Menni Silvano 
Published: March 2015

Background: Differences in age, site, and subtype exist in basal cell carcinoma (BCC). Objective: To evaluate whether an independent association exists between the anatomic location and the histologic subtype of BCC. Materials and Methods: A series of 3,254 BCCs was examined. The location was the head/neck ( n = 1,766), limbs ( n = 362), trunk ( n = 1,113), or genitals ( n = 13). Subtype was classified as superficial, nodular, micronodular, morpheic-infiltrative, or fibroepithelial. Results: Prevalence of BCCs on the head/neck or chest/abdomen increased with age ( p < .001). The prevalence of superficial subtype decreased with age ( p < .0001), whereas the prevalence on nodular subtype increased ( p < .0001). Subtype was associated with location ( p < .0001). The prevalence of superficial subtype was lower among BCCs on the head/neck than other locations (24.9% vs 64.4%, OR 0.18, 95% CI 0.16–0.21). The prevalence of nodular or morpheic/infiltrative subtype was higher among BCCs on the head/neck than other locations, that is, 57.1% versus 29.2%, OR 3.23, 95% CI 2.79 to 3.74 (nodular) and 16.1% versus 4.0%, OR 4.56, 95% CI 3.42 to 6.08 (morpheic/infiltrative). Conclusion: Anatomic location and subtype of BCC were associated with age, but the anatomic location was the only independent predictor of histologic subtype. Although a bias by referral patterns may not be excluded, the results suggest that the anatomic location may favor the development of particular BCC subtypes.
Short-Scar Surgical Approach for the Treatment of Glomus Tumor of the Digit
Authors: Cigna Emanuele , Palumbo Francesca , De Santo Liliana , Zampieri Andrea Edoardo , Soda Giuseppe 
Published: March 2015

Background: A glomus tumor is a biologically benign neoplasm. The traditional surgical approach to treat this tumor boasts the lowest recurrence rates but may cause nail deformities. Objective: A short-scar surgical approach was applied, with the aim of preserving the aesthetics of the nail. Methods: Between January 1999 and January 2009, 25 patients who underwent surgery for a glomus tumor were included in the study. All patients underwent radical resection with three different surgical approaches based on the location of the tumor. Results: All patients who were operated on had complete regression of pain immediately after surgery and at postsurgery follow-ups. Conclusion: The treatment of glomus tumors consists of surgical excision, which is successful if properly executed. Excision of sensitive afferent nervous fibers is a prerequisite to achieve regression of pain. A short-scar surgical approach ensures complete eradication of the tumor and preservation of nail aesthetics.
The Origins of Western Dermatology
Authors: Ross J. Barrie 
Published: March 2015

Objective: On the premise that historical background makes the present more understandable, this review covers the origins of Western dermatology from its Greek and Roman origins through the Middle Ages to the defining moments in the late eighteenth century. Background and Conclusion: The development of major European centers at this time became the background for future centers in the eastern United States in the midnineteenth century and, finally, to the West Coast of the United States and Canada by the midtwentieth century.
Canadian Hand Dermatitis Management Guidelines
Authors: Lynde Charles , Guenther Lyn , Diepgen Thomas L. , Sasseville Denis , Poulin Yves , Gulliver Wayne , Agner Tove , Barber Kirk , Bissonnette Robert , Ho Vincent , Shear Neil H. , Toole Jack 
Published: March 2015

Background: Hand dermatitis (HD) is one of the most common skin conditions; however, it is not a homogeneous disease entity. The severity of HD may range from very mild cases to severe chronic forms, which may result in prolonged disability and, occasionally, refractory HD. Chronic hand dermatitis (CHD) is associated with a high health- economic burden and significant loss of quality of life. Objective: Although numerous treatment options are available, the management of CHD is often difficult and unsatisfactory. There is a paucity of well-designed, randomized, controlled clinical trials in support of the efficacy of established treatment modalities. Conclusion: These guidelines cover the epidemiology, burden, quality of life, etiology, diagnosis, classification, and prevention of HD and provide guidance on management using an approach that is as evidence based as possible.
Long-Term Prognosis and Comorbidities Associated with Psoriasis in the Newfoundland and Labrador Founder Population
Authors: Gulliver Wayne P. , MacDonald Don , Gladney Neil , Alaghehbandan Reza , Rahman Proton , Baker K. Adam 
Published: March 2015

Background: Psoriasis is a common chronic immune-mediated inflammatory disorder of the skin with several associated comorbidities. Objective: To assess the prevalence of comorbidities in a cohort of psoriasis patients within the Canadian province of Newfoundland and Labrador (NL). Methods: This cross-sectional observational study investigated hospital-coded comorbidities associated with psoriasis in comparison to the general NL hospitalized population. Results: Patients died significantly younger than the general population, with patients having an earlier disease onset (≤ 25 years) dying at a younger age than those with a later onset (> 25 years; 59.3 vs 71.2; p = .001). Patients were hospitalized more frequently for several system disorders than the general population, and a potential association was observed between prognostic factors such as age at onset, disease severity, and HLA-Cw6 genotype and certain comorbid conditions. Conclusion: This study supports an association between psoriasis and other conditions, such as circulatory and endocrine diseases.
Effect of Aspirin Pre- and Postburn on Survival of Experimental Intermediate Burns in Rats
Authors: Hadad Eran , Westreich Melvyn , Friedman Tal , Shalom Avshalom 
Published: March 2015

Background: Burns are a major health care problem. Early treatment increases survival of intermediate burn zones, thus decreasing morbidity, mortality, surgery, and hospitalization. Previously, aspirin was shown to improve burn perfusion and increase failing flap survival. Objective: Owing to similarities between failing flaps and intermediate burn zones, we conducted this study to evaluate the effect of aspirin on intermediate burn zone survival. Methods: An intermediate burn was created in 30 rats randomly divided into three experimental groups: pre- and postburn aspirin groups and a control group. Final burn survival was evaluated on day 7. Results: No statistical difference was observed between the test and control groups. Both aspirin regimens failed to improve intermediate burn survival. Conclusion: Presumably, administration of aspirin could not prevent the noxious tissue events of burn injury that cause cell death. Possibly, different dosages or modes of administering aspirin could have a beneficial effect on burn wound survival.
Lupus Miliaris Disseminatus Faciei with Extrafacial Involvement in a 17-Year-Old White Girl
Authors: Mullan Erin , Green Peter , Pasternak Sylvia 
Published: March 2015

Background: Lupus miliaris disseminatus faciei (LMDF) is a benign condition characterized by a papular eruption located in the central face. Histologic studies of the papules show granulomatous infiltrates with central necrosis. The condition is self-limited and usually resolves within 1 to 2 years yet can be cosmetically debilitating, given the location and potential for scarring. Granulomatous periorificial dermatitis similarly affects the face with granulomatous lesions and may overlap clinically with LMDF. Conclusion: This report highlights the challenge in differentiating and treating uncommon granulomatous facial dermatoses.
Two-Stage Reconstruction of Head and Neck Defects after Tumor Resection with a Dermal Regeneration Template
Authors: Felcht Moritz , Koenen Wolfgang , Sassmann Gunther , Goerdt Sergij , Faulhaber Jörg 
Published: March 2015

Background: Large defects after tumor resection in the head and neck area can be reconstructed with local flaps or skin grafts or heal by secondary intention. Especially in elderly patients, a rapid procedure with an acceptable aesthetic and reliable functional outcome is required. Objective: We investigated an alternative strategy using the Integra Dermal Regeneration Template (IDRT) for the reconstruction of large defects. Methods: In 18 patients (75 ± 3 years), 19 extended head and neck defects were treated with IDRT to enhance healing. Results: The mean defect size was 32 ± 7 cm2. The defects were transplanted within a mean postoperative time of 25 ± 2 days and overall showed good cosmetic results and stable scars. The mean follow-up time was 11 ± 1 months. Minor complications were hyperpigmentation (n = 1), small ulcus (n = 1), one minor ectropion (n = 1), and partial loss of the skin graft after immediate radiotherapy (n = 1). In one patient, the silicon layer had to be removed after 8 days owing to partial destruction of the IDRT. We observed shrinkage of 50 ± 4% within 6 months. Conclusion: IDRT is an alternative technique for the reconstruction of extended head and neck defects. It can be conducted without major complications and with a short healing time and acceptable cosmetic results in elderly patients.
Toxic Effects of Skin-Lightening Products in Canadian Immigrants
Authors: Mistry Nisha , Shapero Jonathan , Kundu Roopal V. , Shapero Harvey 
Published: March 2015

Background: The cultural practice of skin bleaching is highly prevalent in Africa. Most reported cases of toxic effects of skin-lightening products occur in this region. Objective: To describe cases of misuse of over-the-counter (OTC) cosmetic skin-lightening products occurring in Canadian immigrants. Methods: Two cases of Canadian immigrants with severe complications from OTC skin-bleaching agents were identified in a community-based dermatology practice in Toronto. The case histories were reviewed and analyzed. Results: A 28-year-old African-Canadian woman developed extensive striae from long-term use of a topical cream containing clobetasol that she had purchased in a Caribbean health food store. A 55-year-old African-Canadian woman developed exogenous ochronosis from the use of a topical bleaching agent she had purchased in Ghana. Conclusion: Cosmetic skin lightening with unregulated topical products occurs in Canada. Dermatologists working in Canada need to be aware of this practice to provide appropriate directive care.
Topical Psoriasis Therapy in the Age of Biologics: Evidence-Based Treatment Recommendations
Authors: Albrecht Lorne , Bourcier Marc , Ashkenas John , Papp Kim 
Published: March 2015

Background: Although the range of therapeutic options has expanded dramatically in recent years, topical agents remain ubiquitous and indispensable tools for treating psoriasis at all levels of severity. The 2009 Canadian psoriasis guidelines considered evidence supporting various monotherapies and combination regimens. Objective: Here we review all approved topical agents, including corticosteroids, calcineurin inhibitors, vitamin D analogues, and retinoids, used in psoriasis and develop additional treatment recommendations, using the Scottish Intercollegiate Guidelines Network (SIGN) system to evaluate strength of evidence, as in the original guidelines. Conclusion: We propose that topical treatments have a place in the long-term management of patients with moderate to severe plaque psoriasis, including those receiving concomitant photo- or systemic therapy. Topical agents are effective and appropriate treatments for psoriasis as long as the physician is attentive to signs of local adverse events and seeks opportunities to reduce the dose or treatment frequency during chronic use.
Hairless Descendants of Mexican Hairless Dogs: An Experimental Model for Studying Hypertrophic Scars
Authors: Kimura Tohru 
Published: March 2015

Background/Objective: In previous studies, the author noticed hypertrophic scar formation in hairless dogs. The purpose of this study was to evaluate both grossly and histopathologically hypertrophic scars in hairless dogs to explore any similarities with hypertrophic scars in humans and to introduce these dogs as an appropriate model for further investigation on hypertrophic scarring. Methods: Full-thickness wounds were made on the dorsolumbar skin of hairless dogs. Hypertrophic scarring was examined with three methods: clinical observations, dihydroxyphenylalanine (DOPA)-positive melanocytes, and skin histopathology. Results: Hairless dogs clinically developed the formation of hyperpigmented and hypertrophic scars that did not extend beyond the original wound margins. In hypertrophic scars of hairless dogs, the split epidermal sheet showed an increased number of DOPA-positive melanocytes with well-developed dendrites exhibiting activated melanocytes. There were very few DOPA-positive melanocytes in the repaired skin of haired dogs. Histopathologic examinations demonstrated that hypertrophic scars were fully reepithelialized and granulation tissue formation was accompanied by inflammatory cell infiltration. There was remodeling of thick collagens and fine elastic fibers in the course of hypertrophic scar formation. Conclusion: Experimental hypertrophic scars produced in hairless dogs have morphologic properties similar to those of human hypertrophic scars.
Pyoderma Gangrenosum: The Great Pretender and a Challenging Diagnosis
Authors: Wong Wendy W. , Machado Gustavo R. , Hill Michael E. 
Published: March 2015

Background: The initial presentation of pyoderma gangrenosum (PG) is virtually indistinguishable from a pyogenic infection, making debridement appear necessary. However, operative approaches often lead to exacerbation and rapid extension through pathergy. Objective and Methods: In attempts to increase awareness of this condition and minimize misdiagnoses, a review of published reports involving PG of the hand and digits was performed and included 35 patients in addition to our case of a 14-year-old female with a history of ulcerative colitis. Results: Of the total cases, 29 patients were misdiagnosed as having an infection and subsequently treated with antibiotics; 13 of these patients also had debridement of their lesions. Twenty-eight patients had associated medical conditions, including ulcerative colitis, Crohn disease, diabetes mellitus, and cancer. Conclusion: When approached with a rapidly growing ulcerated lesion that does not respond to operative therapy, the possibility of PG should be entertained and a high-dose corticosteroid regimen and/or immunomodulator therapy implemented.
Ulerythema Ophryogenes, A Rarely Reported Cutaneous Manifestation of Noonan Syndrome: Case Report and Review of the Literature
Authors: Li Kayi , Thomas Mary Ann , Haber Richard M. 
Published: March 2015

Background: Ulerythema ophryogenes (also known as keratosis pilaris atrophicans faciei) is a rarely reported cutaneous manifestation of Noonan syndrome. Objective: Recognizing ulerythema ophryogenes as a cutaneous association in Noonan syndrome may aid in the diagnosis of this relatively common genetic condition. Methods: We present a case of a patient with Noonan syndrome and ulerythema ophryogenes associated with a SOS1 mutation and review the literature on this association. Results: To the best of our knowledge, this is the second case of Noonan syndrome proven to be due to an SOS1 mutation in which ulerythema ophryogenes was clinically recognized and specifically diagnosed. Conclusions: The presence of ulerythema ophryogenes in a patient with Noonan syndrome increases the likelihood of a SOS1 mutation. Further reports by dermatologists and medical geneticists documenting ulerythema ophryogenes and not just descriptions of sparse or absent eyebrows will help support this genotype-phenotype correlation.
Lyme Borreliosis: An Update for Canadian Dermatologists
Authors: Potok Olivia V. , Brassard Alain 
Published: March 2015

Background: Lyme borreliosis is a multisystemic tick-borne spirochetosis, which may result in dermatologic, musculoskeletal, cardiovascular, and neurologic manifestations. Objective: Patients with suspected acute Lyme borreliosis infection may be referred for urgent dermatologic review. Canadian dermatologists should be aware of the latest information regarding the diagnosis and management of Lyme borreliosis. Methods: This review is based on a PubMed database search combining the word “Lyme” with variations of the word “Canada.” Data sources included articles from the fields of ecology, epidemiology, laboratory diagnostics, and clinical management. Conclusion: In this review, the ecological basis of spirochete transmission by tick vectors is described. The latest available Canadian epidemiologic data are summarized. North American clinical manifestations of Lyme borreliosis are contrasted with European presentations. The Canadian Public Health Laboratory Network's diagnostic guidelines are summarized. Finally, treatment recommendations are outlined.
Adalimumab in Treatment-Resistant Hidradenitis Suppurativa following Recurrence after Extensive Affected Area Excision: A Review of Biologics Therapy
Authors: Samycia Michael , Brassard Alain 
Published: March 2015

Background: Hidradenitis suppurativa (HS) is characterized by chronic, suppurative abscesses, sinus tracts, and fistulas affecting the axilla, groin, and perianal region resulting from hyperkeratosis and occlusion of the terminal hair follicle. Objective: This report highlights the use of biologic agents for the treatment of recalcitrant HS. Method: We report on a 48-year-old male with a 15-year history of refractory perianal-inguinal-buttock HS who, despite receiving numerous surgical drainages and traditional medical treatment for HS, still had severe pain. After trialing etanercept and infliximab with methotrexate, the patient had marked improvement with adalimumab. A literature review of biologics therapy was also performed. Results: After trialing many traditional therapies, we found that adalimumab appears to be the most effective treatment modality for our patient. A literature search revealed 53 articles on biologics therapy in HS. These articles are summarized. Discussion: Biologic agents have been shown to have variable results in the treatment of refractory HS. Enough low-grade evidence has been accumulated to make the use of these agents suitable in HS. Until more clinical trials are performed on this topic, physicians should use clinical judgment when treating HS with biologic agents and be cautious by watching for significant adverse effects.