bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Management of Generalized Pustular Psoriasis with Infliximab: Case Series
Authors: Routhouska Shannon B. , Sheth Pranav B. , Korman Neil J. 
Published: March 2015

Background: Infliximab, a tumor necrosis factor α antagonist, has recently been shown to be successful for the short-term treatment of generalized pustular psoriasis (GPP) in multiple case reports. Objective: The goal of this case series was to assess the efficacy of the longer-term management of GPP with infliximab. Methods: Three patients with severe GPP were followed to assess the efficacy of long-term treatment with infliximab. Results: Infliximab therapy was more efficacious with infusion every 6 to 8 weeks in combination with methotrexate. Conclusion: Infliximab may be efficacious for some patients for the long-term management of GPP. Maintaining a strict infliximab infusion schedule and concomitant methotrexate therapy may decrease infusion reactions and increase efficacy.
Angioma Serpiginosum with Linear Distribution: Case Report and Review of the Literature
Authors: Kalisiak Mike S. , Haber Richard M. 
Published: March 2015

Background: Angioma serpiginosum is a vascular anomaly that classically presents in childhood and predominantly affects females. Objective: To present a case of a young woman with linear distribution of angioma serpiginosum and review the common clinical characteristics and presentation of this condition. Methods: Case report with skin biopsies and dermoscopic findings. Results: A clinical examination revealed numerous irregular punctate red macules in a linear distribution over the right arm. On dermoscopy, the lesions appeared as multiple sharply demarcated red lagoons. The histopathologic findings of dilated blood vessels in the papillary dermis with absence of other changes confirmed the diagnosis of angioma serpiginosum. Conclusion: Angioma serpiginosum is a rare entity that can be distinguished by clinical and histopathologic examinations. Lack of recognition of this condition may lead to unnecessary investigations and delayed treatment.
Effects of Basic Fibroblast Growth Factors on Hypertrophic Scarring in a Rabbit Ear Model
Authors: Xie Julin , Qi Shaohai , Xu Yingbin , Tang Jingming , Li Tianzeng , Liu Xusheng , Shu Bin , Liang HuiZhen , Huang Bing 
Published: March 2015

Background: Basic fibroblast growth factor (bFGF) was clinically proven to accelerate acute and chronic wound healing. Accelerated wound healing may lead to improved scarring. These studies suggested a possible antiscarring effect of bFGF during wound healing. Little was known about the precise pathologic mechanisms of bFGF on scarring formation. Aims: The aim of this study was to investigate the effect of bFGF on hypertrophic scarring in a rabbit ear model and clarify the mechanism of bFGF on scar treatment. Methods: The rabbit model of hypertrophic scarring was created and received of a low- or high-dose topical treatment three times daily for 1, 2, or 3 months. Then we examined the changes in the macroscopic and histopathologic characteristics of the scars. The expression of collagen, α1β2 integrin, and matrix metalloproteinase 1 (MMP-1) was studied by applying reverse transcriptase-polymerase chain reaction, enzyme-linked immunosorbent assay, and Western blotting. Result: High-dose bFGF remarkably alleviated the scar in the rabbit ear model and decreased collagen type I expression. Further study revealed that bFGF remarkably enhanced MMP-1 and decreased α1β2 integrin expression. Conclusion: This study supports the hypothesis that bFGF exerted a net negative effect on collagen remodeling, therefore suggesting a potential antiscarring role.
Diagnosis and Follow-Up of Keratoacanthoma-Like Lesions: Clinical-Histologic Study of 43 Cases
Authors: Magalhães Renata Ferreira , Cruvinel Gabriela Torres , Cintra Geórgia Fontes , Cintra Maria Letícia , Ismael Ana Paula Palu Baltieri , de Moraes Aparecida Machado 
Published: March 2015

Background: Keratoacanthoma (KA) is easily confused with squamous cell carcinoma (SCC) on a clinical or a histopathologic basis. However, KA undergoes spontaneous regression, whereas SCC does not. Objective: Our objective was to study the histopathologic features associated with clinical regression in KA-like lesions to support the therapeutic option. Methods: Forty-three biopsies of KA-like lesions were taken at patient admission. One month later, surgical excision was performed in 18 growing lesions. Regressing lesions were left untreated. Classic histopathologic features and diagnosis were blindly recorded in both biopsies and surgical specimens. Results: On a clinical and a histologic basis, 32 lesions were assessed as KA and 11 as SCC. Features that indicated malignancy were observed in both groups, but the probability of SCC was 31 times higher in tumors with five or more of such features. Several of the histologically atypical lesions were found to regress. Conclusion: SCCs and KAs have more pathologic similarities than differences, especially in the proliferative phase. The combination of the most useful features did not allow the nosologic diagnosis in difficult cases but helped. Differential diagnosis was easier to determine after the 1-month follow up. Complete surgical excision should be indicated in nonregressing and growing lesions.
Repair of the Philtrum: An Illustrative Case Series
Authors: Housman Tamara Salam , Berg Daniel , Most Sam P. , Odland Peter B. , Stoddard Earl 
Published: March 2015

Background: Distortion of the philtrum, which lends considerable symmetry to the midface, leads to a poor esthetic outcome. Objective: This case series describes reconstructive approaches to six philtral defects after Mohs micrographic surgery. Reconstructive approaches including advancement flaps, full-thickness skin grafts, and second-intention healing are illustrated. Postoperative complications included graft hypertrophy, irregularity of the graft surface, graft color mismatch, tenderness, and slight eclabium, which improved with dermabrasion or intralesional triamcinolone. Conclusion: The reasonable success of full-thickness skin grafts demonstrated here provides an additional approach to philtral repairs, especially when combined with traditional advancement flaps.
Open-Label Study to Assess the Safety and Efficacy of Imiquimod 5% Cream Applied Once Daily Three Times per Week in Cycles for Treatment of Actinic Keratoses on the Head
Authors: Rivers Jason K. , Rosoph Les , Provost Nathalie , Bissonnette Robert 
Published: March 2015

Background: Local skin reactions are common during imiquimod treatment of actinic keratosis (AK). Cyclical application of imiquimod may improve tolerability while maintaining efficacy. Objective: To assess the tolerability of imiquimod and clearance rate of AK lesions after imiquimod application. Methods: Imiquimod 5% cream was administered three times per week for 4 weeks followed by 4 weeks of rest (cycle 1) to AK lesions on the head. If AK lesions remained visible at the end of cycle 1, a second treatment cycle was instituted. Results: Fifty percent (30 of 60) of patients experienced complete clearance of AK lesions, and 75% (30 of 40) of patients experienced partial clearance of AK lesions after imiquimod treatment at the end of cycle 2. Moreover, 77% of patients who achieved complete clearance had no visible AK lesions 12 weeks post-treatment. Imiquimod was well tolerated. Conclusion: Imiquimod cycle therapy may be a safe and effective treatment option for AK lesions.
Melanonychia Following Mohs Surgery for Recurrent Squamous Cell Carcinoma in Situ of the Nail Bed
Authors: Lipoff Jules B. , Scope Alon , Busam Klaus J. , Nehal Kishwer S. 
Published: March 2015

Background: Longitudinal melanonychia (LM) is characterized by the appearance of a longitudinal pigmented band in the nail plate. Melanonychia can occur from many causes, including racial predisposition, trauma, drugs, pregnancy, Addison disease, Peutz-Jeghers syndrome, Laugier-Hunziker syndrome, Bowen disease, onychomycosis, benign nail matrix nevi, and melanoma. Objective: We present a case of diffuse melanonychia developing several months following Mohs surgery for a human papillomavirus-induced recurrent squamous cell carcinoma in situ of the nail bed. Conclusions: This case illustrates the diagnostic dilemma in determining the etiology of the melanonychia and considers the differential diagnosis.
Successful Treatment of Chronic Decubitus Ulcer with 0.1% Dirhamnolipid Ointment
Authors: Piljac Ante , Stipčević Tamara , Piljac-Žegarac Jasenka , Piljac Goran 
Published: March 2015

Background: Previous investigations of the biologic activities of dirhamnolipid α-L-rhamnopyranosyl-(1–2)α-L-rhamnopyranosyl-3-hydroxydecanoyl-3–hydroxydecanoic acid have demonstrated that it could be a novel therapeutic agent for wound healing and various immunologic and dermatologic conditions. Objective: The aim of this article is to report the successful treatment of a decubitus ulcer with dirhamnolipid. Methods: The patient was a 90-year-old woman who developed a decubitus ulcer on her right buttock. The patient was initially treated by a standard procedure using pressure reduction, wound management, surgical intervention, and nutrition. The open, full-thickness wound progressed to a size of 10 × 7 cm, with evidence of tissue deterioration. The draining ulcer reached a dimension of 1 × 1.5 × 3 cm. The 0.1% dirhamnolipid ointment was administered at regular intervals, three times daily, by applying a thin layer of ointment directly to the wound area. Photographs were taken at regular 5-day intervals. Results: The standard therapy gave no improvement. Subsequently, therapy with topical dirhamnolipid ointment resulted in a completely healed wound on day 48 of the treatment. Conclusion: This case demonstrates that application of dirhamnolipid resulted in the healing of a chronic decubitus ulcer in an elderly, debilitated patient and might be a useful therapy to improve healing of decubitus ulcers.
Treatment of Vitiligo with Narrow-Band Ultraviolet B: Advantages and Disadvantages
Authors: Abdulla Sonya J. , DesGroseilliers J.P. 
Published: March 2015

Background: Narrow-band ultraviolet B (NB-UVB) therapy for vitiligo is increasingly used in patients who are unresponsive to other forms of therapy. Objective: This study measures levels of patient and physician satisfaction and the associated advantages and disadvantages of NB-UVB. Methods: A retrospective chart review was conducted of the first 50 patients with vitiligo treated at the Photoderm Clinic in Ottawa, Ontario. Data were obtained from digital photographs and patient charts (n = 50). Results: Percent repigmentation of the face and body was very good compared with the hands and feet (poor = 0-< 33%; good = 33-< 66%; very good = ≥ 66%). The physician and patients were satisfied with results achieved with NB-UVB therapy (very good [VG]: medical doctor [MD] 49% [95% CI 35–63], patient [Pt] 51% [95% CI 37–65]; good [G]: MD 24% [95% CI 12–36], Pt 22% [95% CI 10–34]). Conclusion: NB-UVB therapy is an effective treatment for vitiligo (ie, VG, repigmentation ≥ 66%) that leads to high levels of patient and physician treatment-related satisfaction. Although there are disadvantages to NB-UVB therapy, the advantages outweigh the drawbacks. An objective evaluation such as the Vitiligo Area Scoring Index (VASI) is necessary to validate these findings. Additional limitations include those inherent in retrospective study design.
Psychopharmacology in Psychodermatology
Authors: Shukla Rahul , Sasseville Denis 
Published: March 2015

Background: The management of psychodermatologic disease often involves the use of psychotropics by dermatologists. A general approach to the psychopharmacologic management of psychodermatological disease may be of assistance to the dermatologist. Objective: We review and provide a current psychopharmacologically based approach to management of common psychopathologies associated with psychodermatologic disorders, common side effects, and potential drug interactions that may occur with selected psychotropics. Methods: Using relevant MeSH terms, we performed a review of the literature from 1980 to 2006. Results and Conclusions: Effective psychopharmacologic management of psychodermatologic disease involves identifying and basing treatment on the associated psychopathology; familiarity with a variety of psychotropic agents, including antidepressants, anxiolytics, and antipsychotics; and the involvement of a psychiatrist when possible.
Efficacy of a Day-Care Program in the Treatment of Psoriasis
Authors: Zhang Junling , Adam David N. , Stebbing Elaine , Gerbrandt Judith , Lui Harvey , Shapiro Jerry , Zhou Youwen 
Published: March 2015

Background: Few data exist documenting the effectiveness of psoriasis day-care treatment programs (PDTPs) using standardized efficacy measurements. Objectives: We sought to analyze the efficacy of a PDTP using the Psoriasis Area and Severity Index (PASI). Methods: A retrospective review was performed on 132 patients treated at our PDTP. Sufficient data existed to permit PASI analysis using a simplified method for a representative subgroup of 64 patients, who formed the study population. Patients received phototherapy and topical treatments over 2 weeks. The outcome measures included a baseline and day 11 PASI, a physician global assessment (PGA), and adverse events reported by the patients. Results: Mean baseline PASI was 13.6 ( N = 64), with a 59.6% reduction by day 11. A PASI reduction of ≥ 50% was seen in 75% of patients, with 30% of patients achieving ≥ 75% reduction of PASI. Day 11 PGA demonstrated a 69.9% improvement. Conclusion: With a reduction in PASI of 59.6% at 11 days, our PDTP, with phototherapy and topical agents, seems to be a rapid and effective therapy for psoriasis.
Results of Radiation Therapy for Treatment of Classic Kaposi Sarcoma
Authors: Hauerstock David , Gerstein William , Vuong Te 
Published: March 2015

Background: Classic Kaposi sarcoma (CKS) is a vascular neoplasm that primarily affects men of Mediterranean and Ashkenazi Jewish descent. A variety of therapeutic options exist, and choice of treatment depends on clinical form and stage, as well as lesion location and size; options include surgical excision, intralesional interferon α-2b, local or extended field radiotherapy, and chemotherapy. Objective: The aim of this study was to review the outcome of radiation therapy in the treatment of CKS at a single institution. Methods: This retrospective study reviewed patients who receive radiation therapy for histologically confirmed CKS between 1994 and 2006. Results: Sixteen patients were reviewed; the mean age at diagnosis was 74 years, and 13 patients were male. Fifteen patients (94%) presented with leg lesions, and two patients (12.5%) presented with arm lesions. The most commonly prescribed radiation dose was 30 Gy in 15 daily fractions of 2 Gy. All lesions responded to treatment, with a complete response rate of 88% and a partial response rate of 12%. Toxicity was limited to grade I dermatitis (four patients) and grade II dermatitis (two patients). Conclusion: Radiation therapy is an effective treatment modality for CKS and is associated with minimal toxicity.
Tanning Behavior of London-Area Youth
Authors: Gordon Danielle , Guenther Lyn 
Published: March 2015

Background: The World Health Organization recommends that tanning parlors not be used by individuals under age 18 years. The impact of self-tanners on tanning parlor and sunscreen use by Canadian teens is unknown. Objective: To determine teens' use of, knowledge of, attitudes toward, and behavior regarding tanning parlors, self-tanning products, and sunscreen. Methods: Self-report questionnaire of grade 10 students in Thames Valley district, Ontario. Results: Indoor tanning parlors were used by 14%, self-tanners by 28%, and sunscreen daily or most days by 36%. Use was more common in females. There was a strong association between parental and child use of tanning parlors and use of self-tanners. Sixty-two percent believe that self-tanners give adequate photoprotection. Conclusions: Further education is required to address teen tanning parlor use, infrequent sunscreen use, and lack of knowledge about the safety of tanning parlors and self-tanning products.
Skin Thickening in a Hemodialysis Patient: A Case of Nephrogenic Fibrosing Dermopathy
Authors: Al Habeeb Ayman , Partington Sara , Rosenthal Donald , Salama Samih 
Published: March 2015

Background: Nephrogenic fibrosing dermopathy (NFD), a rare fibrosing condition of the skin, occurs in patients with renal failure. Worldwide, 215 cases have been reported, but none of them are from Canada. Case Report: A 71-year-old woman with hypertensive vasculopathy and renal failure, hypothyroidism, deep vein thrombosis, and a previous abdominal aneurysm repair presented with the rapid development of indurated skin over her arms and legs. These skin changes developed 5 months after starting hemodialysis. Biopsy Results: Skin biopsies demonstrated thickened collagen bundles in the dermis with extension into the subcutaneous tissue and minimal increased mucin production. There were increased fibroblastic cells that were immunohistochemically CD34 positive. Conclusions: This patient has the clinical and pathologic features of NFD. Interestingly, this patient had a history of vein thrombosis and vascular surgery, emphasizing the possible role these features may play as instigators of fibrosis in this disease.
Exacerbation of Psoriasis under Efalizumab Therapy
Authors: Rallis Efstathios , Verros Constantinos , Karanikola Evmorfia , Valaskatzi Argyro , Papaconstantis Markos 
Published: March 2015

Background: Efalizumab is a recombinant humanized IgG1-κ isotype monoclonal antibody that binds to CD11a, inhibiting T-cell activation. It has been approved for the treatment of moderate to severe plaque psoriasis. Efalizumab has been associated with the development of skin eruptions during the administration period, and this probably represents the potential psoriasis events observed during its administration. Objective: We report a case of exacerbation of psoriasis under efalizumab administration. A reversible increase in lymphocyte count with normal total white blood cell count was also noticed. Conclusion: Larger series are probably needed to establish clinical and histopathologic criteria and to determine the terminology used regarding the psoriasis adverse events seen with efalizumab treatment.
Granulomatous Periorificial Dermatitis: A Variant of Granulomatous Rosacea in Children?
Authors: Lucas Chere R. , Korman Neil J. , Gilliam Anita C. 
Published: March 2015

Background: We report a case of granulomatous periorificial dermatitis (GPD). A 13-year-old Jamaican boy presented with pink to flesh-colored perioral and periocular papules that erupted during a summer visit to Jamaica. The child was initially diagnosed with sarcoidosis and treated with oral corticosteroids, but the eruption recurred 2 years later. He was referred to Dermatology. Biopsy of one of the facial papules revealed a dense granulomatous infiltrate with surrounding prominent lymphocytes. A diagnosis of GPD was made. Objective and Conclusion: Also known as facial Afro-Caribbean childhood eruption (FACE), GPD occurs in prepubertal children. It can be confused with sarcoidosis, infection, and granulomatous rosacea but contains lymphocytes around the granulomas and lacks the systemic involvement seen in sarcoidosis. Cultures are invariably negative. The histologic features of GPD and granulomatous rosacea can be identical, and certain treatments may exacerbate the condition, highlighting the importance of clinical correlation. The correct diagnosis is important to minimize treatment as GPD is ultimately self-limited.
Nevus Spilus with Synchronous Melanomas: Case Report and Literature Review
Authors: Meguerditchian Ari-Nareg , Cheney Richard T. , Kane John M. 
Published: March 2015

Background: Nevus spilus is a rare, acquired, and often large cutaneous lesion consisting of a light brown background macule containing varying numbers of small darker macular or papular areas. Objective: Nevus spilus may contain dysplastic melanocytic elements, and there are also reports of melanoma arising from nevus spilus. However, the absolute risk for malignant transformation is not well defined. Conclusion: We discuss a case of synchronous melanomas arising from a nevus spilus and potential management recommendations based on a review of the pertinent literature.
Attenuation of α1 Collagen Production with Antisense Ribonucleic Acid in Cultured Hypertrophic Scar Fibroblasts
Authors: Ju-lin Xie , Shao-hai Qi , Tian-zeng Li , Chao-quan Luo , Hou-dong Li , Ying-bin Xu , Xu-sheng Liu , Bin Shu , Huizhen Liang , Yong Huang 
Published: March 2015

Background: It has been demonstrated that hypertrophic scar fibroblasts (HSFs) overexpress collagen messenger ribonucleic acid (mRNA) and protein, especially α1 collagen. Antisense nucleic acids are effective in inhibiting harmful or uncontrolled gene expression, suggesting that antisense ribonucleic acid (RNA) can effectively downregulate the expression of α1 collagen gene and attenuate the scars. Aims: This study was conducted to observe the effect of recombinant plasmid pREP9-COL1 on α1 collagen expression in HSFs and clarify the prospect of antisense RNA on scar treatment. Methods: The α1 collagen gene fragment including the region of 5′ UTR to exon (229 bp) was cloned in the eukaryotic expression plasmid pREP9 in the antisense orientation relative to the RSV-LTR promoter to reconstruct the pREP9- COL1 plasmid. Then it was transferred into HSFs through lipofectamine. The expression of α1 collagen was examined by immunostaining, reverse-transcriptase polymerase chain reaction, and Western blots. Results: The recombinant plasmid pREP9-COL1 with a correct sequence was constructed successfully; pREP9-COL1 consistently inhibited human α1 collagen gene expression at both mRNA and protein levels. Conclusions: Antisense RNA was effective in downregulating α1 collagen expression of HSFs. Therefore, this approach offered a prospect of scar treatment by attenuation of α1 collagen production with antisense RNA.
Alopecia Areata following Adalimumab
Authors: Kirshen Carly , Kanigsberg Nordau 
Published: March 2015

Background: Alopecia areata is a nonscarring hair loss characterized by well-circumscribed patchy areas, most often on the scalp. The inflammatory cytokine tumor necrosis factor alpha (TNF-α), has been connected with the development of alopecia areata in vivo; thus, the TNF-α inhibitors have been cited as possible treatments for this autoimmune condition. Objective: We report a case of alopecia areata that developed in a 52-year-old woman who was recently started on adalimumab for treatment of her psoriatic arthritis. Results: We discuss the previously published cases in the literature linking alopecia areata to TNF-α inhibitor administration. Our case is the first report of a new-onset alopecia areata following adalimumab. Conclusions: Even though TNF-α is implicated in causing alopecia areata, TNF-α inhibitors have paradoxically been associated with new cases of alopecia areata. It is possible that TNF-α may not be involved in the pathogenesis of alopecia areata, as in vitro studies have suggested.