bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minocycline- and Tetracycline-Induced Hypertriglyceridemia in an HIV-Seropositive Patient Receiving Combination Antiretroviral Therapy
Authors: Somani Najwa , Bondy Gregory , Crawford Richard I. 
Published: March 2015

Background: Acne vulgaris may occur as part of immune reconstitution in human immunodeficiency virus (HIV)-seropositive patients on highly active antiretroviral therapy (HAART). Tetracyclines are a common acne treatment. Hypertriglyceridemia has not been reported as a side effect of this drug class. Objective: We report a case of an HIV-seropositive man on HAART (CD4 count 450 cells/μL) who developed isolated hypertriglyceridemia (> 13 mmol/L) after three separate challenges with minocycline or tetracycline, improving each time therapy was discontinued. Results: Based on a review of the literature, this is the first reported case of hypertriglyceridemia with minocycline or tetracycline therapy. No published reports have examined the safety of tetracyclines in the setting of HIV or HAART. Conclusion: A strong temporal association between tetracycline use and hypertriglyceridemia was found without an alternate explanation for the observed lipid profile. Given the common use of tetracyclines in dermatology, we feel that this is an important observation to report.
Primary Systemic Amyloidosis Presenting as Extensive Cutaneous Ulceration
Authors: Alhaddab Mohammed , Srolovitz Herbert , Rosen Nathan 
Published: March 2015

Background: We report a case of primary systemic amyloidosis in a 78-year-old Caucasian woman presented as a nonhealing ulcer on the right thigh for 3 months. Histopathology of the skin revealed widely thickened walls of middermal and subcutaneous vessels from deposition of amorphous eosinophilic material that stained positively with Congo red and crystal violet. Objective: This case represents a very unusual presentation of primary systemic amyloidosis, one in which the cutaneous manifestations provided the first signs of a devastatingly widespread multiorgan infiltration of amyloid protein. Conclusion: This presentation of the disease may signify an advanced stage with a grave prognosis as our patient passed away 3 months after development of the cutaneous ulceration.
Management and Dermoscopy of Fast-Growing Nevi in Pregnancy: Case Report and Literature Review
Authors: Zampetti Anna , Feliciani Claudio , Landi Francesco , Capaldo M.L. , Rotoli M. , Amerio P.L. 
Published: March 2015

Background: The relationship between pregnancy and a change in melanocytic nevi is still controversial. Moreover, management of the rapid evolution of a nevus in an unauspicious melanocytic lesion can be a clinical challenge in pregnancy. Methods: This article examines a case of a fast-growing deep penetrating nevus in a pregnant woman and provides a literature review of articles relative to pregnancy and nevi change, the management of fast-growing pigmented lesions, and the role and usefulness of dermoscopy in these cases. Results: Recent studies have documented that pregnancy is not associated with any significant change in the size of melanocytic nevi. The management of fast-growing melanocytic lesions during this period compulsorily leans toward excision. Dermoscopy can be useful, providing clinicohistopathologic correlations and a better assignment of the lesion. Conclusion: This case report and review provide important management considerations for nevi during pregnancy. Early intervention with aggressive treatment measures is the best management for fast-growing lesions, and epiluminescence dermoscopy can assist the management, although still remaining a second-level examination, useful for documentation and for a better classification of the lesion.
Canadian Consensus Statement on the Use of Intravenous Immunoglobulin Therapy in Dermatology
Authors: Mydlarski P. Régine , Ho Vincent , Shear Neil H. 
Published: March 2015

Background: As a safe, well-tolerated, and potentially beneficial therapy, intravenous immunoglobulin (IVIG) has been increasingly used by dermatologists to treat immune-mediated skin disease. However, practical and comprehensive guidelines for the use of IVIG have yet to be established. Objective: To develop the first Canadian consensus statement on the use of IVIG therapy in skin disease. Methods: A group of Canadian dermatologists convened to discuss current issues in IVIG therapy. The participants reviewed and evaluated the literature and shared clinical experience. Using a modified Delphi process, a consensus statement was developed. Results: Herein we provide a brief overview of pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, mucous membrane pemphigoid, epidermolysis bullosa acquisita, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Recommendations for the management of these diseases are detailed, and therapeutic algorithms for the treatment of various autoimmune mucocutaneous blistering diseases are presented. The appropriate use of IVIG therapy is placed in context for each disease. Conclusion: Although preliminary data suggest that IVIG is a safe and effective therapy for many skin disorders, uncontrolled clinical trials, case series, and anecdotal case reports dominate the literature. Collaborative randomized controlled trials are required to firmly establish the role of IVIG in dermatology.
Biologic Therapeutics in the Treatment of Psoriasis. Part 2: Practical Considerations
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 provide practical guidelines for integration of these agents in the management of psoriasis.
Crafting a Melanoma Educational Campaign to Reach Middle-Aged and Older Men
Authors: Geller Joanna , Swetter Susan M. , Leyson Jenniffer , Miller Donald R. , Brooks Katie , Geller Alan C. 
Published: March 2015

Background: From 1973 through 2002, melanoma mortality rates have risen steeply in middle-aged and older men. Men's higher mortality rate from melanoma is hardly an isolated example of the ways in which men's health lags behind women's health. Given the significantly higher melanoma mortality rates of men compared with women, there is now a need for a melanoma education program targeted to middle-aged and older men and their closest contacts, including spouses, significant others, and health care professionals. Objectives: In this article, we discuss the theoretical and practical foundations for such a program. Then, taking into account factors such as socioeconomic status, health literacy, and residence, we present suggestions for creating such a campaign. Conclusions: Planners for a new educational campaign must understand the target audience's motivations for and perceived barriers to behavioral change. Future studies should examine what motivates certain men to conduct skin self-examinations, ask their physicians about melanoma, and attend melanoma screenings, whereas other men with similar risk factors are less prevention conscious. Issues of health literacy and understandability of our messages must be further explored.
No Show: Incidence of Nonattendance at a Dermatology Practice in a Single Universal Payer Model
Authors: Pehr Kevin 
Published: March 2015

Background: Nonattendance at scheduled appointments is a major problem. Previous studies have shown rates between 17 and 31%. Most US studies found the type of payer to be the greatest determinant of attendance rates. Objectives: This study examines the no-show rate in a private dermatology practice under a single universal payer model, including the effects of old versus new patient, gender, day of the week, month, and weather. Results: The overall rate of nonattendance was lower than in all previous studies (7.79%), with the only statistically significant variable being established versus new patients. Limitations: Certain demographic data investigated in previous studies (eg, age, socioeconomic status) were not assessable. Data are from a single office. Conclusion: The no-show rate in a single universal payer, private practice model is low, especially for established patients.
Efalizumab for the Treatment of Psoriatic Arthritis
Authors: Papp Kim A. , Caro Ivor , Leung Hoi M. , Garovoy Marvin , Mease Philip J. 
Published: March 2015

Background: Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. Efalizumab, a T cell-targeted, recombinant human monoclonal antibody, is approved for the treatment of adult patients with chronic moderate to severe plaque psoriasis. The effect of efalizumab therapy on PsA has not previously been investigated. Objective: This phase II randomized, double-blind, placebo-controlled multicenter study evaluated the efficacy and safety of efalizumab for the treatment of PsA. Methods: Patients were required to be on at least one of the following concomitant systemic therapies for PsA: nonsteroidal anti-inflammatory drugs, corticosteroids, and/or sulfasalazine or methotrexate. One hundred fifteen patients with active PsA were enrolled and randomized in the study. Of these, 107 were treated weekly with efalizumab 1 mg/kg or placebo for 12 weeks, followed by 12 additional weeks of open-label efalizumab. Results: At week 12, 28% of efalizumab-treated patients achieved ACR-20 response (a 20% reduction from the baseline in the American College of Rheumatology response criteria), the primary end point, compared with 19% of placebo patients ( p = .27). The safety profile was comparable between efalizumab- and placebo-treated patient groups, regardless of methotrexate background therapy, and no worsening of joint disease occurred with efalizumab therapy. Conclusions: Efalizumab was not effective in treating PsA; efalizumab therapy did not worsen PsA. The efalizumab safety profile does not appear to be altered with the concomitant use of methotrexate therapy.
Basal Cell Carcinoma: Review of Epidemiology, Pathogenesis, and Associated Risk Factors
Authors: Lear William , Dahlke Erin , Murray Christian A. 
Published: March 2015

Background: Basal cell carcinoma (BCC) is extremely common, and its incidence continues to rise. Objective: This review presents the literature pertaining to the epidemiology, pathogenesis, and risk factors associated with BCC. Conclusions: The risk of developing BCC depends on both genetic predisposition and exposure to risk. Fair-skinned people account for the overwhelming majority of patients, beyond what would be expected by skin phototype alone. Damage to multiple lines of defense appears to be necessary for cancer development and spread. This damage distorts the concerted effort of deoxyribonucleic acid (DNA) repair, immunosurveillance, and cellular growth regulation to protect against malignant progression. Ultraviolet light exposure is the most critical modifiable factor determining early expression and frequency of BCC development.
An Early Selective Medline: Henry Stelwagon's 1916 Textbook of Dermatology
Authors: Jackson Robert 
Published: March 2015

Background: With the rapidly increasing amount of surgical and laser knowledge that has to be learned, we run the risk of not spending enough educational efforts on the morphologic findings on which the specialty of dermatology is based. Objective: To briefly review and evaluate a 1916 dermatology text by Henry Stelwagon. Conclusion: This text has excellent clinical descriptions of diseases. As a bonus, we can find a succinct summary of the world literature up to 1916 on each topic presented.
Pachydermodactyly: Case Report and Review of the Literature
Authors: Al Hammadi Anwar , Hakim Miriam 
Published: March 2015

Background: Pachydermodactyly is a benign form of digital fibromatosis usually presenting in male adolescent patients as asymptomatic nodules on the lateral aspects of the proximal interphalangeal joints of the fingers. It is commonly misdiagnosed as a juvenile rheumatologic condition. Objective and Conclusion: Recognition of the features of this disease will assist dermatologists and rheumatologists in making the diagnosis of this rare condition.
Topical Tacrolimus in the Treatment of Erosive Pustular Dermatosis of the Scalp
Authors: Cenkowski Marta J. , Silver Shane 
Published: March 2015

Background: Erosive pustular dermatosis of the scalp (EPDS) is a rare condition characterized by chronic, sterile, pustular erosions leading to scarring alopecia. Although the etiology is unknown, it appears to be associated with ultraviolet light exposure and trauma. Histologic findings include nonspecific atrophy of the epidermis and chronic inflammation. Case History: A 71-year-old female presented with a 1-year history of a boggy, erythematous, friable plaque on the vertex of her scalp. A diagnosis of EPDS was made based on presentation, negative cultures, and histologic findings. Initial therapy with intralesional and topical steroids and oral antibiotics resolved the inflamed plaques; however, steroid-induced atrophy became prominent after 5 months of use. The treatment was discontinued, resulting in recurrence of disease. Topical tacrolimus 0.1% ointment was initiated, which has been successfully controlling the lesions with reversal of skin atrophy and clinical evidence of hair growth. Conclusion: This is the fourth reported case of the successful treatment of EPDS with topical tacrolimus for the resolution of atrophy and the prevention of relapse of inflammation. Although its long-term use warrants close follow-up for side effects, tacrolimus may constitute a novel therapeutic option for the treatment of EPDS.
Histologic Spectrum of Melanocytic Nevi Removed from Patients > 60 Years of Age
Authors: Martinka Magda , Bruecks Andrea K. , Trotter Martin J. 
Published: March 2015

Background: The histology of melanocytic nevi removed from older patients often differs from that of nevi from younger adults. According to the literature, the most common nevus in older individuals is the intradermal nevus, and purely junctional nevi are rare and should alert the pathologist to a possible melanoma precursor. Objective: To evaluate the histologic features of melanocytic nevi removed from patients > 60 year of age. Methods: Biopsies of nevi ( N = 215) from 172 patients > 60 years (mean age 69 ± 7 years) were examined retrospectively by three dermatopathologists, a consensus diagnosis was rendered, and the spectrum of histologic features was documented. Results: Junctional melanocytic nevi were frequently diagnosed in older patients (21% of cases) and a lentiginous, often heavily pigmented growth pattern was common (12% of nevi). Severely atypical (dysplastic) changes were found in 6% of nevi removed from older patients. Conclusions: We conclude that benign junctional nevi are relatively common in older patients and that a lentiginous, heavily pigmented growth pattern, traditionally associated with younger individuals, is often seen in both junctional and compound nevi in this older age group. This pattern must be differentiated from dysplastic nevus and melanoma in situ, which they may clinically resemble.
Should We Consider Hypohidrotic Ectodermal Dysplasia as a Possible Risk Factor for Malignant Melanoma?
Authors: Gregoriou Stamatis , Rigopoulos Dimitris , Vergou Theognosia , Korfitis Chrysovalantis , Menegakis George , Kontochristopoulos George 
Published: March 2015

Background: Hypohidrotic ectodermal dysplasia (HED) is a rare multisystem disorder that typically affects hair, teeth, nails, and sweat glands in combination with abnormalities of ectodermal originated tissues. Objective: To raise the issue of whether heightened awareness is required in the follow-up of pigmented lesions in patients with HED. Methods/Results: Two patients with HED are reported. The first had a history of two malignant melanomas, whereas the second presented with a novel malignant melanoma. Conclusion: Although a prospective epidemiologic study to determine the incidence of malignant melanoma in patients with HED is virtually impossible and the probable pathogenesis warrants further investigation, these two case reports, in conjunction with other recent reports associating other ectodermal dysplasias with malignant melanoma, suggest that heightened awareness might be prudent in the follow-up of pigmented lesions in patients with HED.
Development and Validation of a Comprehensive Acne Severity Scale
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: Although more than 25 acne grading systems exist, only 2 are inclusive of truncal acne. There is neither a gold standard nor a consistently used standardized system. Purpose: Our purpose was to develop and validate an acne grading system incorporating severity at the face, chest, and back. Methods: We developed a comprehensive acne severity scale (CASS) by modifying a preexisting facial acne scale, the Investigator Global Assessment, to include truncal acne. The validity and responsiveness of CASS grades were correlated with Leeds scores at baseline and after 6 months of standard acne treatment. Results: Spearman correlations were significant between Leeds and CASS grades for the face (0.823), chest (0.854), and back (0.872), respectively ( p < .001). After 6 months of therapy, changes in these scores were also significantly correlated ( p < .001) at all three sites. Conclusion: Concurrent validity of CASS is demonstrated by a very strong correlation with Leeds grading. CASS is simpler to use than the Leeds system and more appropriate for translation of research trial results to clinical practice.
Gianotti-Crosti Syndrome in Two Adult Patients
Authors: Ting Patricia T. , Barankin Benjamin , Dytoc Marlene T. 
Published: March 2015

Background: Gianotti-Crosti syndrome was first described in Italy by Gianotti in 1955. It is considered a benign, self-limited exanthem that occurs in younger children. Adult cases are rare. Objective: We report two cases of Gianotti-Crosti syndrome in a previously healthy 37-year old Asian and 21-year old Caucasian female. Methods/Results: Histopathological analysis of 4-mm punch biopsies from the upper extremity of both patients revealed an interstitial dermatitis with mild to moderate perivascular lymphocytic infiltrate and occasional scattered eosinophils in the superficial and mid-dermis. Clinicopathological correlation was consistent with Gianotti-Crosti syndrome. Conclusion: Since both patients experienced significant pruritus, patient 1 was initially treated with a high potency topical corticosteroid followed by a two-week course of oral prednisone and patient 2 was treated with a potent topical corticosteroid. Both patients were asymptomatic at follow-up 3 to 4 weeks after their initial presentation.
North American Efficacy and Safety of a Novel Pediculicide Rinse, Isopropyl Myristate 50% (Resultz)
Authors: Kaul Nalini , Palma Kathleen G. , Silagy Stewart S. , Goodman J. John , Toole Jack 
Published: March 2015

Background: Head lice infestations are a major nuisance in school-aged children and are a worldwide public health problem. There are growing concerns about the effectiveness of current treatments owing to increasing resistance, safety, and patient noncompliance. A safe, easy to use, effective alternative is needed. Objective: A pediculicide rinse, 50% isopropyl myristate (IPM), was assessed in two phase 2 trials conducted in North America. The first trial was a nonrandomized (proof of concept) trial without a comparator conducted in Winnipeg, Canada. The second trial, conducted in the United States, was an evaluator-blinded, randomized superiority trial comparing 50% IPM rinse with a positive control (RID; pyrethrin 0.33%, piperonyl butoxide 4%). The primary end points were to determine the safety and efficacy of 50% IPM as a pediculicide rinse. Methods: Subjects meeting inclusion criteria were enrolled in the above-mentioned trials with efficacy end points 7 and 14 days post-treatment. Subjects were also evaluated on days 0, 7, 14, and 21 for the presence of erythema and edema using the Modified Draize Scale. Other comments associated with the safety evaluation (ie, pruritus) were collected. Results: IPM was found to be effective in the proof of concept study and comparator trial using a positive control. IPM was also well tolerated, with minimal adverse events. All adverse events were mild, resolving by completion of the study. Conclusion: Data suggest that IPM is a safe and effective therapy for the treatment of head lice in children and adults. IPM's mechanical mechanism of action makes development of lice resistance unlikely.
Case Report of Primary Rectal Melanoma and Review of the Etiology of Melanoma
Authors: Fratesi Lauren , Alhusayen Raed , Walker James 
Published: March 2015

Background: Primary rectal melanoma is a very rare and aggressive malignancy. It is defined as melanoma arising in the rectal mucosa, more than 4 cm from the anal verge. Objective: A case of primary rectal melanoma is reported, and the theories of the etiology of melanoma are reviewed. Methods and Results: This article reports a case of a 75-year-old woman who presented with lower gastrointestinal bleeding and abdominal discomfort. A polyp was removed from the low-lying rectum during colonoscopy. After immunohistochemical staining and microscopic examination, it was diagnosed as melanoma. Conclusion: In light of primary melanoma in sun-shielded regions such as the rectum, theories of causation other than sun exposure merit consideration. Factors such as genetics, immunosuppression, and virus infections, as well as ultraviolet radiation, may play a role in the etiology of melanoma.
Dermatologic Immune Restoration Syndrome: Report of Five Cases from a Tertiary Care Center in North India
Authors: Handa Sanjeev , Narang Tarun , Wanchu Ajay 
Published: March 2015

Background: Dermatologic conditions are often an early clue to human immunodeficiency virus (HIV) infection. As the disease progresses and the host immunity fails, patients may develop a number of skin conditions. At this point, they have a dominant T helper 2 immunologic response. After the initiation of antiretroviral therapy, the T helper 1 response is restored, and some skin problems, paradoxically, make their appearance then. Conclusion: Herpes zoster, mucocutaneous herpes, eosinophilic folliculitis, and mycobacterial infections have been known to occur at this stage. This may be because immune restoration of a host's immunity causes recognition of silent or latent infection and results in development of the condition. We report five cases that were seen at our center during a 2-year period.