bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Canadian Self-Administered Online Survey to Evaluate the Impact of Moderate-to-Severe Psoriasis among Patients
Authors: Wasel Norman , Poulin Yves , Andrew Robin , Chan Daphne , Fraquelli Elisa , Papp Kim 
Published: March 2015

Background: Few population studies of individuals living with psoriasis have been performed in Canada. Objective: The objective of this survey was to understand the severity and impact of psoriasis on the lives of Canadian patients. Methods: An online survey was conducted using a consumer panel. Eligible subjects reported a diagnosis of psoriasis and provided a self-reported level of severity. In addition, subjects had to either (a) have psoriasis covering at least 3% of their body surface area; (b) have psoriasis on a sensitive area of the body; or (c) be currently undergoing treatment for their psoriasis with systemic medication and/or phototherapy. Results: A total of 514 panelists met the inclusion criteria and completed the survey. Current moderate, severe, or very severe psoriasis was reported by 65% of respondents. Nearly all subjects (96%) had psoriasis affecting a sensitive area of the body. At the time of the survey, 18% were taking systemic medication and/or phototherapy. Comorbidities, such as obesity and high blood pressure, were highly prevalent, with 75% of respondents reporting at least one other diagnosis. Data from the SF-8 and Dermatology Life Quality Index instruments indicated that psoriasis negatively impacted quality of life. Conclusion: Moderate-to-severe psoriasis places a burden on Canadian patients, some of whom may be receiving suboptimal treatment or treatment not appropriate for the severity of their condition.
Exacerbation of Darier Disease by Lithium Carbonate
Authors: Ngo Jennifer , Haber Richard 
Published: March 2015

Introduction: Darier disease (DD) and Hailey-Hailey disease (HHD) are rare autosomal dominantly inherited genodermatoses with mutations in the respective genes, ATP2A2 and ATP2C1, that encode the respective calcium adenosine triphosphatases SERCA2 and PMRI/SPCA1. Lithium is an effective therapy used in psychiatry as prophylaxis against recurrent mania and to treat acute schizoaffective, impulsive, and alcoholic disorders. Methods: We discuss a patient with DD who claimed that her skin condition had flared after she was administered lithium therapy for bipolar disorder. Discussion and Conclusions: DD may flare after lithium therapy, an association that has rarely been reported. Not uncommonly, DD has been observed to coexist with affective disorders, with reports of the bipolar disorder susceptibility locus cosegregating with a separate DD gene. A mechanism by which lithium worsens disease has recently been studied in rats. DD's coexistence with affective disorders and the mechanisms by which lithium may cause exacerbation of DD and HHD are reviewed.
Ultraviolet Light-Induced Leukoderma of the Scalp Associated with Androgenetic Alopecia: Senescent Actinic Depigmentation of the Scalp
Authors: Verma Shyam B. , Wollina Uwe 
Published: March 2015

Background: Human scalp skin is normally protected from sunlight and ultraviolet radiation by the presence of hair. When hair loss occurs, for example, in androgenetic alopecia, this protective factor declines. Objective: We report a series of 10 type IV and V skin patients with a male predominance (60–85 years). All patients suffered from androgenetic alopecia starting from the age of around 40 to 45 years. They all noticed asymptomatic, well-defined, depigmented macules, which were seen only in areas that have been afflicted by androgenetic alopecia. The depigmented macules remain within the confines of the hair margin. There has been no depigmented lesion elsewhere on the body. The patients did not report any association with any drug that they may have started taking. There is no history of vitiligo in these patients or their families. Biopsy samples taken from three of the patients showed solar elastosis. Conclusions: The entity of ultraviolet-induced scalp leukoderma and androgenetic alopecia has not been acknowledged in dermatology textbooks but needs consideration for its importance in differential diagnoses. The term senescent actinic depigmentation of the scalp is suggested.
The Burden of Psoriasis and Barriers to Satisfactory Care: Results from a Canadian Patient Survey
Authors: Mahler Ronald , Jackson Christine , Ijacu Horia 
Published: March 2015

Background: The physical, mental, social, and financial burdens experienced by Canadians with psoriasis are relatively unexplored. Objective: To gain an understanding of the impact of psoriasis on Canadians. Methods: An online survey, “Stand Up and Speak Out,” was provided to Psoriasis Education Program users who had given consent to be contacted. Results: Ninety-five percent of respondents had moderate to severe psoriasis, a high proportion relative to similar studies. Respondents reported medical and psychological comorbidities, with prevalence up to fourfold higher than Canadian background rates. Respondents also reported reduced income and increased unemployment, at levels that increased with psoriasis severity. Use of biologics was associated with high levels of satisfaction relative to other treatment options. However, biologic use was not uniform but was strongly correlated with insured status and annual income. Conclusion: In this severely affected population of Canadians with psoriasis, the physical, mental, social, and financial burden of disease was high.
Canadian Case Report of Erythema Nodosum Leprosum Successfully Treated with Prednisone and Thalidomide
Authors: Saber Mélissa , Bourassa-Fulop Caroline , Bouffard Danielle , Provost Nathalie 
Published: March 2015

Background: Erythema nodosum leprosum (ENL) is a disease rarely encountered in Canada. It is characterized by multiple remissions and recurrences, often requires long-term treatment, and can result in debilitating sequelae. Objective: To promote rapid recognition and adequate therapy for ENL. Methods: Case report of a 39-year-old man diagnosed with an ENL. The clinical and histopathologic features, treatment provided, and response to treatment are detailed in this article. Results: ENL presented itself as painful cutaneous lesions on the face and limbs, bilateral paresthesia of the fourth and fifth fingers, and systemic symptoms. Prednisone 40 mg daily for a week and then 60 mg daily for another week reduced the lesions by 80% and the pain by 50%. Although prednisone 60 mg daily was continued for one more week and then stopped, thalidomide was started at a dose of 300 mg daily for 4 weeks and then reduced gradually, which led to complete resolution. Conclusion: At the 7½-month follow-up, the patient remained completely asymptomatic.
Drug-Induced Hepatitis and Lupus during Infliximab Treatment for Psoriasis: Case Report and Literature Review
Authors: Poulin Yves , Thérien Geneviève 
Published: March 2015

Background: Infliximab (IFX) can induce elevation of hepatic aminotransferase levels. Hepatitis has been reported in patients treated with IFX and with risk factors such as viral hepatitis, alcohol intake, or concomitant use of hepatotoxic drugs. Liver disorders occurring in a patient without risk factors have rarely been reported, and liver biopsies to substantiate the liver changes have very rarely been described. The presence of lupus-like symptoms with newly positive antinuclear antibodies (ANAs), sometimes with double-stranded deoxyribonucleic acid (DNA) antibodies, has also been reported with IFX. Only a few articles have reported in detail these types of adverse events in patients with psoriasis. To our knowledge, the combination of lupus-like symptoms with simultaneous occurrence of a biopsy-proven hepatitis has not been reported with the use of IFX for psoriasis. Objective: Description of a case of drug-induced hepatitis in a patient with concurrent clinical and serologic features of lupus induced by IFX. Methods: We present the case of a 40-year-old woman with psoriasis who developed a biopsy-proven drug-induced hepatitis and concurrent lupus symptoms with positive ANAs while under IFX treatment. A review of related publications is presented. Conclusion: The clinician must be aware of uncommon side effects of IFX, such as liver anomalies and development of autoantibodies. Liver enzymes should be monitored regularly, and ANAs should be checked if liver enzymes are increasing and in the presence of lupus symptoms.
The Green Monster: Stokes's 1944 Modern Clinical Syphilology
Authors: Jackson Robert 
Published: March 2015

Background: There is much information on the life and accomplishments of John Hinchman Stokes (1885–1961), the dermatologist and syphilologist. There is little detailed information on his 1944 classic text on syphilis, Modern Clinical Syphilology. Objective: To review and critique this book. Methods: A careful review of the book, his life, and the accomplishments that were undertaken in relation to the age in which he lived. Results: The book is indeed a goldmine of information of all aspects of syphilis from pre–World War I (1905) until the late (1944) World War II era. Conclusion: The factors that make it a classic are as follows: (1) the disease had a specific cause; (2) Stokes's 25-year obsession with the disease; (3) there was no effective simple cure for most of the time he was studying it; (4) Stokes was an obsessive, intelligent, well-trained physician; (5) he lived in a well-developed, reasonably stable country; and (6) he was able to see how the disease could be adequately treated with penicillin and compare these events with those in the prepenicillin era.
Updated Review of the Pathogenesis and Management of Merkel Cell Carcinoma
Authors: Zampetti Anna , Feliciani Claudio , Massi Guido , Tulli Antonello 
Published: March 2015

Background: Merkel cell carcinoma is a rare, aggressive, malignant cutaneous tumor of the elderly or immunosuppressed individuals that usually appears on sun-exposed areas of the body. Its pathogenesis is still debated, and, currently, no standardized treatment exists. Objective: To provide a current updated review of the most relevant data concerning the pathogenesis and management of Merkel cell carcinoma. Methods: Using relevant MeSH terms, we performed a review of the literature on these subjects from 1980 to June 2009. Results and Conclusion: The current management of Merkel cell carcinoma is based on surgical excision as the majority of patients present with localized disease, whereas up to 30% have regional lymph node metastases. In these cases, the best outcome is achieved with multidisciplinary management that includes radiotherapy. Chemotherapy is part of the treatment in advanced cases and is mandatory for distant metastatis. Given that a recent work showed the presence of a previously unknown polyomavirus, which the authors called Merkel cell polyomavirus, the therapeutical approach to Merkel cell carcinoma could be reconsidered in the future.
Psoriasis Care: New and Emerging Pharmacologic Trends
Authors: Papp Kim A. , Carey Wayne 
Published: March 2015

Background: The first Canadian Guidelines for the Management of Plaque Psoriasis were recently published, reflecting an evidence-based analysis of psoriasis therapies available in Canada. The guidelines advocate patient-centered psoriasis care in which physicians explore appropriate options to find safe therapies that patients will adhere to and be satisfied with over the long term. Objective: To update the discussion in the guidelines regarding new and emerging therapies and trends in psoriasis clinical research. Methods: Searches of Medline and clinicaltrials.gov were undertaken to identify new and emerging psoriasis therapies as of March 2009. Results: Since May 2008, when published evidence was evaluated for the guidelines, one new drug, ustekinumab, has been approved for moderate to severe psoriasis. New formulations and combinations of existing drugs are expected to reach the Canadian market shortly. Novel agents continue to move through clinical development. Conclusion: With the introduction and removal of antipsoriatic therapies from the Canadian market, the therapeutic landscape continues to shift. An increasing number of head-to-head comparisons and the reporting of ambitious treatment outcomes will simplify physicians' evaluation of treatment options. Recognition of quality of life as a key goal of psoriasis treatment is another hopeful trend, consistent with the principles of patient-centered care.
Skin Disease and Stigma in Emerging Adulthood: Impact on Healthy Development
Authors: Roosta Neda , Black David S. , Peng David , Riley Lee W. 
Published: March 2015

Background: Visible skin disorders can limit healthy psychosocial development in several domains owing to the stigma these disorders create. Objective: To assess if emerging adults with acne and eczema perceive stigma in diverse developmental domains resulting from their visible skin conditions. Methods: A convenience sample of 336 emerging adults attending a diverse public university in northern California completed a Web-based survey. Multivariate modeling was used to determine if eczema and acne result in perceived stigma. Results: The mean (SD) age of respondents was 20.1(1.5) years; most were white (43.2%) and female (62.5%). Almost half (47%) reported acne and 16.4% reported eczema. The likelihood of experiencing perceived stigma was 1.6 (95% CI 1.13–2.27, p < .001) times higher for those with eczema compared to those without eczema, and the likelihood of experiencing perceived stigma was 3.19 (95% CI 2.41–4.22, p < .0001) times higher for those with acne compared to those without acne. Conclusions: Our findings indicate that emerging adults perceive stigma as a result of their acne and eczema in several important developmental domains. The results suggest that acne may have a stronger relationship with perceived stigma than eczema, perhaps owing to its greater visibility on the body. University-based activities are recommended to support those with skin disease.
Epidemiology of Moderate-to-Severe Plaque Psoriasis in a Canadian Surveyed Population
Authors: Papp Kim , Valenzuela Fernando , Poulin Yves , Bernstein Geula , Wasel Norman 
Published: March 2015

Background: Limited data are available on the epidemiologic features of psoriasis in Canada. Objective: To investigate the epidemiologic features and burden of moderate-to-severe psoriasis in a Canadian population. Methods: An online survey was conducted using a consumer panel. Eligible respondents indicated a diagnosis of psoriasis and plaque-type psoriasis of at least moderate severity. Eligibility was validated according to self-reported body surface area (BSA) involvement, sensitive areas affected, and/or current treatment. Results: Of the 514 respondents who completed the survey, 62% estimated a BSA involvement of ≥ 3% within the past 5 years. Onset of psoriasis occurred earlier in females than in males. Nail involvement was more commonly reported in individuals with psoriatic arthritis compared to those without. Several symptoms were more likely described as “constantly” or “near constantly” experienced by females than by males. Comorbidities commonly reported were hypertension, dyslipidemia, and overweight or obesity. Conclusions: The findings are consistent with a substantial burden attributed to moderate-to-severe plaque psoriasis in a Canadian population.
Pyogenic Granuloma of the Foot with Satellitosis: A Role for Conservative Management
Authors: Bacher Janice , Assaad Dalal , Adam David N. 
Published: March 2015

Background: Pyogenic granuloma (PG) with satellitosis is a rare phenomenon that typically occurs in children and teenagers. It can be seen after excision or trauma to the original lesion. Objective: The aim is to review an atypical case of PG with satellitosis and to highlight a conservative approach to management. Methods: This article includes a case report of a 48-year-old woman developing PG with satellitosis in her right foot and includes a review of the literature. Results: There are few cases of PG with satellitosis in the literature. Our patient differs from most given her age and the location of the lesions. She was managed differently with a conservative observational approach, and, over time, her symptoms abated. Conclusion: PG with satellitosis can occur in varying patient populations with varying presentations. Although several treatment options exist, managing patients conservatively should be considered an approach to management. Early investigations should be conducted to rule out more sinister items in the differential diagnosis.
Effects of Avotermin (Transforming Growth Factor β3) in a Clinically Relevant Pig Model of Long, Full-Thickness Incisional Wounds
Authors: Laverty Hugh G. , Occleston Nick L. , Johnson Mark , Little John , Jones Richard , Fairlamb David , Ferguson Mark W.J. , O'Kane Sharon 
Published: March 2015

Background: The pig is an accepted species for evaluating the safety of molecules in dermal wound healing indications; however, the sizes of wounds assessed have not always been comparable to large incisions encountered clinically. Objective: To develop a clinically relevant model of incisional wounding in the Göttingen minipig for assessing the safety and tolerance of compounds in development to improve scarring. Methods: Intradermal avotermin (recombinant transforming growth factor β3 [TGFβ3]) up to 6,000 ng/100μL was administered twice to 20 cm full-thickness incisions. Results: Incisions were well tolerated in the minipig. Avotermin treatment was not associated with adverse changes in a range of clinical parameters, including wound healing and strength. Plasma TGFβ3 levels were transient with ≈0.1% bioavailability. Conclusion: A clinically relevant model of long, full-thickness, sutured surgical incisions in the minipig is achievable. Avotermin is well tolerated in this model and does not adversely affect normal wound healing at levels that significantly exceed those doses to be used clinically in humans.
Health-Related Quality of Life in Patients with Psoriasis
Authors: Jankovic Slavenka , Raznatovic Milena , Marinkovic Jelena , Jankovic Janko , Kocev Nikola , Tomic-Spiric Vesna , Vasiljevic Nadja 
Published: March 2015

Background: Psoriasis is a chronic skin disease that has a significant impact on patients' lives. Objective: The purpose of the study was to assess factors that might influence the health-related quality of life (HRQoL) of patients with psoriasis. Methods: We conducted a cross-sectional study of 110 outpatients with psoriasis. To assess the HRQoL, The Short Form 36 Health Survey (SF-36) and Skindex-29 were administered. Stressful life events during the last 12 months were assessed with Paykel's Interview for Recent Life Events. Results: HRQoL was significantly more impaired in older patients, those with age at onset of 40 years or more, who had a positive family history and who experienced stressful life events in the 12 months preceding the interview. Sex and clinical severity were not significantly related to patients' HRQoL. Conclusion: Psoriasis patients have poorer HRQoL than the general population. This study supports the decision to use both generic and skin-specific instruments to assess the impact of psoriasis on HRQoL.
Primary Cutaneous Folliculotropic and Lymphohistiocytic Anaplastic Large Cell Lymphoma
Authors: Bittencourt Achiléa L. , de Oliveira Rodrigo Ferreira , Santos Jussamara Brito 
Published: March 2015

Background: Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) is a T-cell lymphoma that presents in the skin and consists of CD30+ anaplastic large lymphocytes with abundant cytoplasm and pleomorphic nuclei. In addition to the classic variant, several other histologic patterns of ALCL have been identified, among them the lymphohistiocytic variant. Objective and Methods: We describe a case of the lymphohistiocytic variant of PC-ALCL with a marked follicular involvement. The lesion appeared as a single nodule in the face that completely regressed following biopsy. A diffuse infiltration of lymphocytes and macrophages was seen in the dermis associated with hypertrophied hair follicles, follicular mucinosis, and marked folliculotropism, leading to follicular disruption. Cohesive groups of CD30+ large, atypical lymphocytes with a high proliferative index were seen focally. The patient was followed up for 41 months, during which time no relapses occurred. Conclusions: This case shows that PC-ALCL may present with different histologic features, including a follicular variant, that may mimic both benign and malignant conditions.
Versatile Punch Surgery
Authors: AlGhamdi Khalid M. , AlEnazi Madallah M. 
Published: March 2015

Background: Punch instrument is a circular blade that can be used for many diagnostic and therapeutic purposes in different medical and surgical specialties. Punch surgery (or biopsy) is achieved by using this versatile punch blade under local anesthesia. Basic punch surgery is quick and easy to learn. Complications such as bleeding and infection are minimal. Diagnostic punch surgery can obtain a part of or whole skin lesion for histologic examination. In addition to the skin, nail and mucous membrane tissue can be obtained by punch biopsy. Interestingly, punch biopsy can be used as an adjunctive to fine-needle aspiration to establish the diagnosis of tumors of solid organ such as the breast. Diagnostic punch surgery can be modified to overcome certain problems. The split-punch technique helps avoid crushing the tissue punch when trying to divide it for different examinations. The double-trephine punch facilitates obtaining subcutaneous tissue without the need for full elliptical excision. The string-of-beads technique obviates the need for dissection of tissue into pieces. In other nondermatology and dermatology conditions, such as nerve pathology, arteriosclerosis, melanoma mapping, and eyelid tumors, the diagnosis can be enhanced with the use of punch surgery. Therapeutic punch surgery can be used for excision of unwanted lesions such as nevi, as well as pathologic bone and cartilage tissues. Punch grafting is used in vitiligo surgery and hair transplantion. Punch evacuative surgery can help in the evacuation of unwanted tissue or materials such as lipoma, subungual hematoma, scrotal calcinosis, pseudocyst of the auricle, pilar cyst, and others. Reconstructive punch surgery includes correction of ear lobe defects and acne scars. Enhancement of wound healing can be achieved by use of the punch; therefore, it can help nonhealing ulcers.
Promising Results from a Pilot Study on Compression Treatment of Ear Keloids
Authors: Hassel Jessica C. , Löser Christoph , Koenen Wolfgang , Kreuter Alexander , Hassel Alexander J. 
Published: March 2015

Background: Ear keloids continue to be a therapeutic challenge. Objective: To evaluate the clinical success of a modified “oyster splint technique.” Methods: Ten patients with an ear keloid agreed to receive the compression therapy. After surgical removal, a compressive device made of acrylic resin was applied on top of a silicone gel sheet and patients were asked to wear the splint 23 hours a day for at least 8 months. If the scar showed a tendency to grow, corticosteroids were injected intralesionally. In addition to recurrence rate, other parameters and wearing times were obtained by an interview. Results: Two of 10 patients experienced a recurrence in a mean follow-up period of 18.2 months (range 4–44 months). The daily wearing time of the compression splint was critical for the success of the treatment ( p = .022). The splint had to be worn at least 10 hours a day for a minimum of 8 months to prevent recurrence. However, the need for additional intralesional steroid injections was significantly lower in patients wearing the splint for more than 20 hours per day ( p = .048). The splint treatment was painless for 80% of patients. The therapeutic result was given a median mark of 1.75 (1 = best, 6 = worst). Conclusion: Although it requires considerable time and effort, the technique seems to be a promising therapy.