bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral Extensive Periorbital Milia en Plaque Treated with Electrodesiccation
Authors: Al-Mutairi Nawaf , Joshi Arun 
Published: March 2015

Background: Milia en plaque (MEP) is a rare form of milia. Only 25 cases of this rare condition have been reported to date ( MEDLINE search). Only one previous case of MEP has been treated with electrodesiccation. Objective: To report a new case of this rare condition and present the outcome with electrodesiccation. Conclusion: The case is being reported here to highlight the features of this rare but now well-recognized dermatologic condition, which has been reported increasingly in the recent past, to discuss the various treatments tried, and to share our experience of treating patients with the simple, inexpensive, easily available, and nonsophisticated office procedure of electrodesiccation.
Lipolysis of Lipomas in Patients with Familial Multiple Lipomatosis: An Ultrasonography-Controlled Trial
Authors: Bechara Falk Georges , Sand Michael , Sand Daniel , Rotterdam Sebastian , Stücker Markus , Altmeyer Peter , Hoffmann Klaus 
Published: March 2015

Background: Surgery of multiple lipomas, as in patients with familial multiple lipomatosis, is often limited by poor aesthetic outcome owing to extensive scarring. For this reason, phosphatidylcholine (PDC) has been widely used to treat areas of localized fat accumulation. However, no reports of lipoma therapy with intralesional application of PDC, that is, injection lipolysis, have been published to date. Objective: To investigate whether injection lipolysis with PDC is an effective therapeutic option for patients with multiple lipomas. Methods: Thirty lipomas in 10 patients were sonographically measured prior to treatment. Four injections at intervals of 6 to 8 weeks were done. Sonographic measurements of lipoma size were repeated before each injection. Side effects, a pain score using a visual analogue scale, and patient satisfaction were noted. In one lipoma, histologic changes after lipolysis are described. Results: After four injections, a significant reduction in size of 45.8% was achieved. No complete elimination was seen in any lipoma. Histology showed a mild granulomatous septal panniculitis. Hematoma occurred in eight cases (27%). Four patients described pain on pressure for 3 days after injection. No severe side effects or systemic reactions were observed. Conclusion: Although surgery is the gold standard for lipoma therapy, injection lipolysis with PDC can also significantly reduce lipoma size. Complete elimination was not observed in any lipoma. Given that this was a short-term study, long-lasting therapeutic effects and possible recurrence of lipoma cannot be evaluated.
Dermatologic Signs
Authors: Freiman Anatoli , Kalia Sunil , O'Brien Elizabeth A. 
Published: March 2015

Background: Dermatology signs serve as important clues to primary skin disorders and internal conditions. Objective and Methods: To highlight major cutaneous signs based on a MEDLINE literature search from 1966 to March 2006. Results and Conclusions: A multitude of signs exist in dermatology. Appreciation and knowledge of cutaneous signs will enhance the care of patients with dermatologic manifestations.
Predominant Dermoscopic Patterns Observed among Nevi
Authors: Scope Alon , Burroni Marco , Agero Anna Liza Chan , Benvenuto-Andrade Cristiane , Dusza Stephen W. , Rubegni Pietro , Bono Riccardo , Dell'Eva Giordana , Salaro Cristina , Marghoob Ashfaq A. 
Published: March 2015

Background: It has been clinically observed that patients' “normal” moles resemble each other. Whether this concept is applicable to dermoscopic practice has not been sufficiently studied. Objective: To investigate whether physicians evaluating dermoscopic images would identify common dermoscopic profiles of nevi within individual patients. Methods: Images of 205 nevi belonging to 18 patients were evaluated by 2 dermatologists for dermoscopic global pattern, color, and specific structures. We defined dermoscopic patterns as dominant if seen in ≥ 40% of the patient's nevi; a minor pattern was defined as 20 to 39%. Results: A dominant pattern was seen in 15 patients (83%). In 13 (72%) of the patients, ≥ 80% of the nevi were classified into one, two, or three global patterns. The reticular global pattern was the most prevalent dominant pattern, seen in 9 patients (50%); the homogeneous pattern was the most prevalent minor pattern, seen in 16 patients (89%). Conclusion: Individuals tend to have one to three predominant dermoscopic nevus global patterns.
XP-828L in the Treatment of Mild to Moderate Psoriasis: Randomized, Double-Blind, Placebo-Controlled Study
Authors: Poulin Yves , Bissonnette Robert , Juneau Christina , Cantin Kim , Drouin Rejean , Poubelle Patrice E. 
Published: March 2015

Background: XP-828L, a protein extract obtained from sweet whey, has demonstrated potential benefit for the treatment of mild to moderate psoriasis in an open-label study. Objective: To study in a randomized, double-blind, placebo-controlled study the safety and efficacy of XP-828L in the treatment of mild to moderate psoriasis. Design: XP-828L 5 g/d (group A, n = 42) or placebo (group B, n = 42) was given orally for 56 days followed by XP-828L 5 g/d in group A and by XP-828L 10 g/d in group B for an additional 56 days. Results: Patients receiving XP-828L 5 g/d for 56 days had an improved Physician's Global Assessment (PGA) score compared with patients under placebo ( p < .05). Considering the data of group A only, the PGA score improved from day 1 to day 56 ( p < .01); the Psoriasis Area and Severity Index score improved as well, but to a lesser extent ( p < .05). Conclusion: Oral administration of 5 g/d XP-828L compared with a placebo significantly improved the PGA score of patients with mild to moderate psoriasis.
Treatment of Mycosis Fungoides: Overview
Authors: Freiman Anatoli , Sasseville Denis 
Published: March 2015

Background: Mycosis fungoides (MF) is the most common clinicopathologic subtype of primary cutaneous T-cell lymphoma. Objective: The therapy of MF is highlighted in this overview. Results and Conclusions: Skin-directed MF therapies include topical corticosteroids, nitrogen mustard, carmustine (BCNU), topical bexarotene gel, imiquimod cream, radiotherapy, total skin electron beam therapy, and phototherapy. Systemic therapies include extracorporeal photopheresis, interferon, oral bexarotene, denileukin diftitox, monoclonal antibodies and cytokine therapy, and other systemic chemotherapy. Finally, some investigative therapeutic modalities are presented.
Are Narrow-Band Ultraviolet B Home Units a Viable Option for Continuous or Maintenance Therapy of Photoresponsive Diseases?
Authors: Haykal Kay-Anne , DesGroseilliers Jean-Pierre 
Published: March 2015

Background: Phototherapy is an effective treatment for several photoresponsive diseases. Many patients are unable to attend hospital-based treatment and prefer home phototherapy. Objectives: The purpose of this study is to survey patients who were prescribed home phototherapy to determine the viability of narrow-band ultraviolet B home units in the continuous or maintenance treatment of photoresponsive diseases. Methods: A patient questionnaire was prepared focusing on different areas of interest: the reason for choosing home therapy, appropriate teaching, previous medical treatment, present exposure therapy, improvement of the condition, side effects, regular dermatologic follow-ups, and the effectiveness of this approach. Twenty-seven patients who attended the photodermatology clinics at the Sisters of Charity of Ottawa Health Service at the Elisabeth Bruyère Health Centre in Ottawa and the Ottawa Hospital Civic Campus were contacted, and they completed a questionnaire by telephone or electronic mail. Results: Twenty-five patients completed the questionnaire. One refused to participate, and one was out of the country. The main reasons for choosing home phototherapy were time (40%), travel expenses (25%), difficulty with work schedule (17%), and recommendation by a physician (6%). Other reasons included loss of earnings, personal stress, knowledge that the disease recurs when phototherapy is discontinued, moving from the city, personal stress, and the convenience of being at home. Regarding the effectiveness of the home phototherapy, 24 patients (96%) viewed the home unit approach to be effective. All patients agreed that they would continue the treatment; they would repeat it, and they would recommend it. Few patients reported side effects, such as erythema (36%), blisters (1%), pruritus (8%), and dryness (1%). Fourteen patients (56%) reported not experiencing any side effects. Conclusion: Narrow-band ultraviolet B home phototherapy was found to be an effective form of maintenance therapy for photoresponsive diseases. It is safe and presents few side effects when patients receive appropriate guidelines, teaching, and follow-ups.
Biologic Therapeutics in the Treatment of Psoriasis. Part 1: Review
Authors: Langley Richard G. , Gupta Aditya K. , Cherman Andrea M. , Inniss Kimberley A. 
Published: March 2015

Background: Psoriasis is a chronic inflammatory skin disease principally mediated by activated T cells, which release proinflammatory cytokines with reactive epidermal changes in the skin, producing the characteristic lesions of psoriasis. New research into possible treatment options has been inspired by increased understanding of the pathophysiology of psoriasis and advances in immunology and molecular biology permitting the development of targeted, highly active biologic agents. Objective: The aim of this article is to review the efficacy and safety of five biologic therapeutics in the treatment of moderate to severe psoriasis and to provide practical guidelines for integration of these agents in the management of psoriasis. Methods: We searched MEDLINE (1966–2005) for articles containing the key words: alefacept, efalizumab, etanercept, infliximab, and adalimumab and searched recent conference abstracts. Results: Emerging immunotherapeutic agents (fusion proteins, recombinant cytokines, fusion toxins, or antibodies) target T cells or cytokines responsible for plaque formation that is characteristic of psoriasis. Alefacept is the first biologic to be approved in both the United States and Canada. More recently, efalizumab and etanercept and infliximab have been approved in the United States and Canada for plaque-type psoriasis. Adalimumab is currently in phase III clinical trials. Conclusion: These novel biologics offer an intriguing and effective treatment option for patients with moderate to severe psoriasis.
Cutaneous Sarcoidosis Successfully Treated with Alefacept
Authors: Garcia-Zuazaga Jorge , Korman Neil J. 
Published: March 2015

Background: Sarcoidosis is a systemic granulomatous disease of unknown etiology that affects multiple organ systems, including the pulmonary, lymphatic, skeletal, and integumentary systems. Improved understanding of the intrinsic immunology and molecular biology in sarcoidosis can be applied to the treatment of this disease. Alefacept is a human fusion protein consisting of the extracellular domain of leukocyte function-associated antigen 3 fused with the Fc portion of human immunoglobulin G1. It works by blocking the interaction between antigen-presenting cells and T cells to inhibit activation and by inducing apoptosis of CD4+ T cells. In this case report, we describe a 46-year-old patient with recalcitrant lupus pernio who was successfully treated with alefacept. Objective: To determine whether T-cell inhibition, specifically the use of alefacept, may be used to treat a patient with recalcitrant cutaneous sarcoidosis. Methods: Case report. Results: There was a modest clinical improvement after 8 weeks of intramuscular injections of alefacept. Conclusion: This case report provides further evidence of successful treatment of sarcoidosis with biologic agents directed against T-lymphocyte activation.
Lack of Significant Skeletal Changes after Long-Term, Low-Dose Retinoid Therapy: Case Report and Review of the Literature
Authors: Halverstam Caroline P. , Zeichner Joshua , Lebwohl Mark 
Published: March 2015

Background: Long-term systemic retinoid therapy has been associated with skeletal side effects. There have been reports of diffuse idiopathic skeletal hyperostosis (DISH) syndrome, calcification of ligaments, and osteoporosis, as well as premature fusion of epiphyses and modeling abnormalities of long bones, occurring in patients on chronic high-dose isotretinoin, etretinate, and acitretin therapy. Low-dose acitretin has been used for many years as monotherapy or in combination with other systemic therapies for psoriasis. Evidence to date suggests that the frequency of symptomatic bony effects is quite low in these patients. Objective: To present the radiologic findings of a patient on long-term, low-dose acitretin and etretinate and to review the literature on the radiologic evidence of skeletal side effects during retinoid therapy. Methods: Case report and literature search. Results: A patient on low-dose acitretin had no significant radiologic abnormalities associated with retinoid use after 9 years of treatment. A review of the literature revealed conflicting reports on the incidence of radiologic abnormalities in patients on retinoid treatment. Conclusion: The evidence to date does not substantiate a clear link between radiologic skeletal abnormalities and long-term, low-dose acitretin or etretinate therapy.
Cutaneous Rosai-Dorfman Disease: Comprehensive Review of Cases Reported in the Medical Literature since 1990 and Presentation of an Illustrative Case
Authors: Frater John L. , Maddox Jessica S. , Obadiah Joseph M. , Hurley M. Yadira 
Published: March 2015

Background: The latest comprehensive review of primary cutaneous Rosai-Dorfman disease was published as part of an exhaustive survey of sinus histiocytosis with massive lymphadenopathy in 1990. Since then, much progress has been made in the understanding of malignant lymphoma and benign disorders of lymphoid and histiocytic origin. Objective: We reviewed cases of primary cutaneous Rosai-Dorfman disease published since 1990 and discuss their clinical and pathologic features, comparing them with cases of systemic Rosai-Dorfman disease. Methods: We conducted a search of the National Library of Medicine PubMed database for cases of cutaneous Rosai-Dorfman disease reported in the English-language medical literature since February 1990. Results: We identified 72 patients with cutaneous Rosai-Dorfman (female to male ratio 1:0.5). The gross appearance and number or distribution of lesions were highly variable. Abnormal laboratory data included peripheral blood cytopenias (10 patients) and increased gammaglobulin fraction (10 patients). The response to treatment was variable. Conclusion: Purely cutaneous disease without the characteristic lymphadenopathy is rare but has been increasingly reported in the literature. Compared with patients with systemic Rosai-Dorfman disease, patients with primary cutaneous Rosai-Dorfman disease are older, women are more commonly affected, and whites are more likely than blacks to be afflicted.
Socioeconomic Status and The Prevalence of Melanoma in Ontario, Canada
Authors: Haider Aamir , Mamdani Muhammad , Shear Neil H. 
Published: March 2015

Objective: To determine if an association exists between the prevalence of melanoma and socioeconomic status based on income gradients in a large population of over 12 million people in Ontario, Canada. Methods: A population-based cross-sectional study using administrative health care databases was conducted. Individuals were divided into five income quintiles based on median neighborhood household income. A Mantel-Haenszel extension test was used to assess whether there was a gradient in the prevalence of melanoma across income groups. Multivariate logistic regression was used to determine if median neighborhood income predicted the prevalence of a melanoma, independent of gender, age, and urban-rural residence status. Results: The study cohort consisted of 14,623 patients with melanoma. Between the lowest income group of $37,637 and the highest income group of $84,162, the prevalence of melanoma increased by 225%. Our study also identified an association between melanoma prevalence and rural residence. The overall prevalence rate was 30% ( p < .01) higher in rural areas compared with urban areas. Conclusion: A higher socioeconomic status and rural versus urban residence status appear to be significant risk factors for the development of melanoma in Ontario.
Surgical Treatment of Facial Cutis Verticis Gyrata with Direct Excision
Authors: Beier Justus P. , Kneser Ulrich , Horch Raymund E. 
Published: March 2015

Background: Cutis verticis gyrata (CVG) is a rare deformity of the skin presenting with thick gyrated folds and ridges, involving predominantly parts of the head and the face. Objective: We report on aspects of the surgical treatment of facial CVG based on our experiences with four patients, who had developed a progressive and enormous thickening and an extraordinary strong gyration of the facial skin. Methods: A single or staged repeated straightforward surgical treatment with direct excision of abundant and thickened gyriform folds, in one case accomplished by an upper face-lift, was performed. Results: Direct excision within the lines of tension resulted in a major reduction of the facial skin distortion, a reduced scalp, and facial skin thickening and avoided maceration in all four patients. The quality of life was considerably improved in all patients. Conclusion: Direct excision of gyriform skin is a successful surgical approach to the rare skin deformity of CVG.
Perifolliculitis Capitis Abscedens et Suffodiens in an 18-Year-Old Aboriginal Canadian Patient: Case Report and Review of the Literature
Authors: Varshney Nishi , Al Hammadi Anwar , Sam Hakeem , Watters A. Kevin 
Published: March 2015

Background: Perifolliculitis capitis abscedens et suffodiens (PCAS) is a suppurative process that involves the scalp, eventually resulting in extensive scarring and irreversible alopecia. This condition often presents in males of African American origin. Objective: This article describes the clinical presentation, diagnosis, and treatment of an Aboriginal Canadian male suffering from PCAS. A literature review on the etiology, pathology, differential diagnosis, and management is also discussed. Conclusion: Careful analysis of the pathology and clinical presentation can aid in the timely diagnosis and management of this challenging condition. The clinician dealing with patients suffering from PCAS has several treatment options available to help successfully manage patients with straightforward or recalcitrant disease.
Weight of Decision-Making Impairs Clinical Assessment of Melanocytic Lesions
Authors: Gächter Tamara , Mühleisen Beda , Schärer Leo , Dummer Reinhard , Burg Günter , Hofbauer Günther F.L. 
Published: March 2015

Background and Objective: We studied the weight of decision-making on clinical assessment of melanocytic lesions judging benign, atypical, and malignant lesions; common mistakes; and total removal rates, comparing dermatologists with nondermatologists. Methods: Of 11,246 histopathology specimens, 3,768 had a clinical assessment of melanocytic lesions. Histopathologic diagnosis served as the gold standard. Results: Benign nevi were assessed most accurately (77%). Dermatologists assessed benign nevi better (p < .0001). The accuracy of clinical assessment in atypical nevi and melanoma was lower (23% and 42%, respectively). Seborrheic keratosis was the most common mistaken diagnosis. Complete removal of clinically benign nevi, atypical nevi, and melanoma was 84%, 90%, and 89%. Decision-making impaired clinical assessement of melanocytic lesions by 5% for dermatologists and 9% for nondermatologists. Conclusion: The accuracy of clinical assessment of melanocytic lesions is high for benign nevi, with dermatologists outperforming nondermatologists. Clinicians overestimated malignant potential. Complete removal was more frequent in suspicious lesions. Clinical decision-making impaired assessment by 5 to 9%.
Jean Darier and His Précis
Authors: Jackson Robert 
Published: March 2015

Background: Many dermatologists know the name Jean Darier. Few are familiar with his accomplishments. The contemporary dermatology scene, with its emphasis on surgery and laser, is in danger of forgetting its roots in living gross pathology. Objective: To describe in summary form Darier's excellent dermatology text, Precis de Dermatologie, with particular emphasis on its organization and morphologic approach to skin disease. Conclusion: Knowledge in some areas of dermatology has increased manyfold since Darier's Précis was first published. This does not apply to current clinical descriptions of disease found in many current texts and journal articles. A study of Darier's Précis would be an excellent start to reinvigorate morphologic knowledge in dermatology.
Treatment of Focal Hyperhidrosis
Authors: Murray Christian A. , Cohen Joel L. , Solish Nowell 
Published: March 2015

Background: Focal hyperhidrosis is not rare, affecting over 2.5% of the population. This condition is often socially and professionally debilitating, leading to significant quality of life impairment. It most commonly involves the axillae, palms, soles, and face. Objective: To review hyperhidrosis and discuss and compare the treatment options currently available. Conclusions: Topical or systemic therapies may be helpful for patients with mild disease. Invasive surgical options, although often effective, are limited by complications. More recently, botulinum toxin injection has proven to be a safe and successful treatment for hyperhidrosis and results in high patient satisfaction. Botulinum toxin A (Botox, Allergan Inc., Irvine, CA) is currently approved in the United States, Canada, the United Kingdom, and many other countries for the treatment of axillary hyperhidrosis and is routinely used off-label for other anatomic sites.
Acrokeratosis Paraneoplastica (Bazex Syndrome) Presenting in a Patient with Metastatic Breast Carcinoma: Possible Etiologic Role of Zinc
Authors: Taher Muba , Grewal Parbeer , Gunn Beth , Tonkin Katia , Lauzon Gilles 
Published: March 2015

Background: Bazex syndrome (acrokeratosis paraneoplastica) is a rare paraneoplastic syndrome that usually occurs in males over 40 years old and is particularly associated with squamous cell carcinoma of the upper aerodigestive tract and adenopathy above the diaphragm. Objective: The objectives of our article are (1) to describe a unique case of acrokeratosis paraneoplastica and (2) to review the current literature regarding skin findings, commonly associated neoplasms, and treatment options relative to this condition. Patient: We describe a 68-year-old female with lobular breast carcinoma, complicated by local and distant recurrences, who presented with a 1-year history of prominent acral skin and nail changes. Results: Our patient's clinical skin findings improved significantly following treatment and partial remission of her underlying malignancy. Conclusions: Our patient represents one of few females described with this syndrome, which is especially rare in association with lobular breast carcinoma. Further, the patient's presentation is unique as she was discovered to demonstrate laboratory findings consistent with coexistent porphyria cutanea tarda and relative zinc deficiency.