bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Electronic Psoriasis and Arthritis Screening Questionnaire (ePASQ): A Sensitive and Specific Tool to Diagnose Psoriatic Arthritis Patients
Authors: Khraishi Majed , Mong Jonathan , Mugford Gerry , Landells Ian 
Published: March 2015

Background: We report on an electronic version of the Psoriatic Arthritis Screening Questionnaire (ePASQ), a sensitive and specific tool for diagnosis of psoriatic arthritis (PsA) in patients with plaque psoriasis. Objective: To validate the ePASQ against the original paper version. Method: The ePASQ scores 15 points on 10 weighted questions and a 68-joint diagram. Data were collected from a prospective cohort of 42 patients with early PsA meeting the Classification Criteria for Psoriatic Arthritis (CASPAR) criteria and from 12 plaque psoriasis patients without PsA. Results: The receiver operating characteristic curves for the ePASQ group yielded an optimal 97.62% sensitivity and 75.00% specificity, for a cutoff score of 7. A cutoff point of 8 yielded 88.10% sensitivity and 75.00% specificity. Concordance of the paper and electronic scores was very high. Conclusion: The ePASQ is a sensitive and specific tool to screen for PsA. The simple electronic administration and automatic scoring minimize clinician involvement and increase the potential for wider distribution.
Teaching Dermatology to Canadian Undergraduate Medical Students
Authors: Kirshen Carly , Shoimer Ilya , Wismer Judy , DesGroseilliers Jean-Pierre , Lui Harvey 
Published: March 2015

Background: The Canadian dermatology undergraduate curriculum was reviewed in 1983, 1987, and 1996. All surveys revealed the limited amount of time dedicated to dermatology in the undergraduate curriculum. Objective: This survey was designed to obtain current information regarding undergraduate dermatology teaching in Canadian medical schools. Methods: A survey was sent electronically to all undergraduate dermatology curriculum coordinators at each of the 17 Canadian medical schools. Results: Between 1996 and 2008, the average number of hours of dermatology teaching has increased by 7 hours to 20.5 ± 17.2 hours. Again, most of the teaching is performed in the preclinical years. The majority of schools would like to have more time dedicated to dermatology teaching; however, many schools cited a restriction in the number of dermatology faculty members, with an average of 7.8 ± 7 dermatologists, as a barrier to education delivery. Conclusion: It is important to have dermatology included throughout the undergraduate medical curriculum because most dermatologic problems are seen by nondermatologists. Respondents at each school believed that there may be value in moving toward a national strategy for dermatology curriculum changes, and this can ensure both uniformity and consistency within Canada.
Break Dancing: A New Risk Factor for Scarring Hair Loss
Authors: Monselise Assaf , Chan Lisa J.Y. , Shapiro Jerry 
Published: March 2015

Background: We report on a first case of lichen planopilaris (LPP) mimicking androgenetic alopecia (AGA) in an individual who has been break-dancing on his head for many years. LPP is an autoimmune inflammatory scalp condition that when left untreated can result in scarring and irreversible hair loss. The etiology of LPP is unknown. Different treatment modalities are used for LPP and AGA. Objective: To increase the awareness of physicians to the possibility of scarring hair loss (LPP) presenting like AGA. Results: Scalp examination showed scarring patches of hair loss. A scalp biopsy confirmed the diagnosis of LPP. Conclusion: Chronic scalp trauma due to break dancing may be a trigger for LPP. A meticulous scalp examination should be performed before making a diagnosis of nonscarring conditions of hair loss such as AGA. Early recognition of LPP and appropriate treatment are important before scarring and irreversible hair loss ensue.
A Refresher on Herpes Zoster, Current Status on Vaccination, and the Role of the Dermatologist
Authors: Guenther Lyn C. , Lynde Charles W. 
Published: March 2015

Background: Herpes zoster (HZ) and postherpetic neuralgia (PHN) have a significant impact on quality of life. PHN is often chronic and difficult to treat. Dermatologists have always been involved in making the diagnosis of these conditions and, most recently, teaching the need for early antiviral therapy. Objective: With the introduction of a new vaccine, HZ and its difficult-to-treat complication PHN can be prevented or minimized. Preventive medicine is important and has been supported by dermatologists with sun safety programs. Patients receiving biologics are at increased risk of developing zoster. Conclusion: Dermatologists should embrace zoster vaccination and recommend routine vaccination of immunocompetent individuals > age 60 years, as well as patients of any age who are starting immunosuppressants, including biologics. Given that individuals over age 50 years are at risk for PHN and studies have shown that the vaccine's immunogenicity and safety are maintained in individuals age 50 to 59 years, vaccination in this age group may be considered. Some dermatologists may consider vaccinating their own patients, but most will likely recommend that vaccination be performed by their patients' primary care physicians.
Kaposi Sarcoma of the Penis in an HIV-Negative Patient
Authors: Cecchi Roberto , Troiano Michela , Ghilardi Maurizia , Bartoli Laura 
Published: March 2015

Background: The penis is an unusual site of presentation for Kaposi sarcoma, especially in immunocompetent patients. Case Presentation: A 52-year-old human immunodeficiency virus (HIV)-seronegative man presented with a reddish, 8 mm in diameter nodule on the glans penis near the coronal sulcus. Histopathology after excision of the lesion was consistent with Kaposi sarcoma. No other cutaneous or mucosal manifestations were present. After a follow-up period of 2 years, no recurrence was observed. Conclusion: This unusual case suggests that Kaposi sarcoma should be considered in the differential diagnosis of macular, papular, and nodular lesions involving the penis.
Cutaneous Manifestations of Modern Technology Use
Authors: Li Kayi , Barankin Benjamin 
Published: March 2015

Background: Modern-age technology is increasingly implicated in traditional dermatologic conditions. Objective: This review provides a concise overview of the cutaneous manifestations from modern technology use. Methods: We describe a case of laptop computer–induced erythema ab igne and provide a review of the literature pertaining to the etiology, clinical features, diagnosis, and management of reported cases of dermatoses resulting from the use of modern technology. Results: Sources of modern technology implicated in the reported cases include video games, laptop computers, personal computers and accessories, and smart and cellular phones. These presentations have primarily been localized to the extremities, particularly the hands and face. Diagnoses were associated with trauma or repetitive strain, irritant contact dermatitis, or allergic contact sensitivities. Removal of the offending agent was most often described as effective in symptom resolution. Conclusion: It is important to consider modern-age sources as part of the index of suspicion for diagnosing traditional dermatologic conditions. These manifestations will likely increase over time with the pervasive popularity and use of modern technology. Early recognition of the offending agent will be beneficial in differentiating the etiology for effective management.
Facial Nerve Danger Zone in Dermatologic Surgery: Temporal Branch
Authors: Dahlke Erin , Murray Christian A. 
Published: March 2015

Background: The principal function of cranial nerve 7 (CN VII), the facial nerve, is to provide motor innervation to the muscles of facial expression. The temporal branch of the facial nerve primarily innervates the frontalis muscle, which raises the eyebrow. Objective: To present a case that illustrates the importance of facial nerve anatomy to skin surgery practice. Conclusion: The relevant surgical anatomy of the temporal branch is reviewed, as well as clinical practice points around nerve damage in skin surgery.
A Challenging Case of Multiply Recurrent Nasal Basal Cell Carcinoma
Authors: Mohammed Fazilat , Solish Nowell , Murray Christian A. 
Published: March 2015

Background: Basal cell carcinoma (BCC) is the most common human malignancy worldwide and represents a significant cost to health care systems. Most cases occur on the head and neck, and many are successfully treated with relatively simple measures. However, if high-risk or complicated cases are not treated effectively, they may result in considerable disfigurement or morbidity. We report on a patient with a complex nasal basal cell carcinoma (BCC) that failed multiple treatments by electrodesiccation and curettage (EDC). Management strategies for primary and recurrent BCC, including EDC, standard excision, Mohs micrographic surgery (MMS), and radiation therapy, are discussed. This case required extensive resection, and we review the literature for predictive factors of significant subclinical spread. Objective: To present a complex case that illustrates the management options of high-risk, recurrent BCC of the head and neck. Materials and Methods: Case report and review of the literature. Results: MMS offers the lowest recurrence rate in the treatment of recurrent BCC in surgical candidates. A validated risk scale may predict subclinical spread in patients with BCC of the head and neck. Conclusions: BCC can progress to locally advanced disease, necessitating definitive treatment. EDC performed by an experienced dermatologist may offer cure rates comparable to those of surgery in lower-risk BCC. However, in higher-risk tumors, such as recurrent or larger lesions, methods that ensure clear margins should be considered first line, especially in sensitive locations. The routine use of a validated risk scale can better prepare patients and dermatologists for potentially extensive resections. In cases with risk of extensive involvement, strategies to clearly communicate options and progress at all stages of the process should be available.
Support Needed to Involve Psoriasis Patients in Treatment Decisions: Survey of Dermatologists
Authors: Tan Jerry , Stacey Dawn , Barankin Benjamin , Bissonnette Robert , Gulliver Wayne , Lui Harvey , Shear Neil , Bhatti Shahid 
Published: March 2015

Background: Little is known about the interaction between dermatologists and their patients in facilitating treatment decisions for psoriasis. Purpose: Our objective was to determine dermatologists' perceptions of the needs of psoriasis patients in treatment decisions. Methods: Dermatologists were invited to complete an 18-item online survey on the treatment of psoriasis, including questions on decision-making roles, factors they considered important to patients in treatment decisions, and patients' needs for decision support. Results: Seventy dermatologists completed the survey (15% response rate). The highest rated factors in decision making were access to physicians for discussion (86%) and information about the risks and benefits (80%); the latter was more frequently reported by those ≥ 50 years ( p = .021). Treatment-specific factors of greatest importance were side-effect profile (87%) and cost (80%). Potential hindrances were patient misconceptions about disease, inadequate patient education materials, patient indecision, and inadequate physician time. Conclusion: Although dermatologists consider accessibility to dermatologists and information on treatment risk and benefits to be important in treatment decision making, they report time with patients and educational materials to be inadequate. Limitations: The small sample size may limit the generalizability of our findings.
Worsening of Vitiligo and Onset of New Psoriasiform Dermatitis following Treatment with Infliximab
Authors: AlGhamdi Khalid M. , Khurrum Huma , Rikabi Ammar 
Published: March 2015

Background: Vitiligo is a depigmentation disorder caused by melanocyte destruction that possibly results from an autoimmune mechanism. Psoriasis is an immune-mediated, chronic, inflammatory dermatosis. Although tumor necrosis factor α antagonists (anti-TNF-α), such as infliximab, are effective in treating psoriasis, many cases reported in the literature indicate that psoriasis might also be induced by treatment with infliximab. Some studies also suggest that TNF-α antagonists might be an effective treatment for vitiligo because the disorder is characterized by increased levels of TNF-α, indicating that it might play a role in the pathogenesis of this disease. Objective: We report a case of psoriasiform dermatitis with vacuolar interface reaction that occurred after infliximab therapy in a patient with vitiligo. Method: A 17-year-old male patient with vitiligo vulgaris was treated with an intravenous infusion of 5 mg/kg of infliximab at 0, 2, and 6 weeks and then once every 6 weeks over a span of 6 months. The patient was monitored both clinically and with laboratory investigations. He had no personal or family history of psoriasis. He tolerated the treatment well, without side effects. However, he developed a biopsy-proven psoriasiform lesion for the first time 4 months after he completed his sixth dose of infliximab. His vitiligo also worsened. Conclusion: This case report shows that infliximab given for vitiligo did not improve the disorder and that the vitiligo actually progressed. Moreover, psoriasiform lesions developed after this therapy. Further studies are needed to identify the effects of infliximab in patients with vitiligo.
Early Surgical Excision of Giant Congenital Hemangiomas of the Scalp in Newborns: Clinical Indications and Reconstructive Aspects
Authors: Santecchia Luigino , Valassina Maria Francesca Bianciardi , Maggiulli Federica , Spuntarelli Giorgio , De Vito Rita , Zama Mario 
Published: March 2015

Background: Infantile hemangioma is the most common vascular tumor in newborns, with an incidence from 12 to 23% among preterm infants with low weight at birth and a female to male ratio of 3:1. The head and neck is the most frequently affected area (60%), and the scalp is a typical site for such large lesions. Objective: We describe some clinical and medical aspects in comparison with the surgical approach to giant infantile hemangioma of the scalp. Methods: The indications to treatment are discussed. An outcome basis evaluation, by reviewing some clinical cases, is provided to help readers better understand when and how to undergo surgery safely. Conclusion: Early excision of huge infantile hemangioma of the scalp is the treatment of choice if feasible within 5 months of age.
Successful Intravenous Immunoglobulin Treatment of Atypical Lichen Myxedematosus Associated with Hypothyroidism and Central Nervous System Involvement: Case Report and Discussion of the Literature
Authors: Macnab Magnus , Kenny Patrick 
Published: March 2015

Background: Lichen myxedematosus (LM) is a rare idiopathic disorder characterized by papules, plaques, and/or nodules in the skin secondary to mucin deposition and variable dermal fibrosis in the absence of thyroid disease. Case reports are the predominant literature on LM due to its rarity, and the data are limited regarding the disease. No standard treatment regimen exists, and the response to treatment varies. Objective: This report adds to the limited literature on atypical LM associated with thyroid dysfunction and contributes to the growing body of evidence supporting intravenous immunoglobulin (IVIg) as effective therapy for extensive cases. Methods and Results: We report an unusual case of atypical LM associated with hypothyroidism, central nervous system (CNS) disturbances, and atrial fibrillation in a 64-year-old male. The patient experienced remarkable improvement within 3 months of beginning IVIg treatment; however, he required repeat therapy due to the recurrence of CNS symptoms 3 months after treatment. Conclusion: We agree with previous authors that thyroid dysfunction alone should not preclude a diagnosis of LM. Additionally, we contribute to the increasing evidence of IVIg being an effective treatment, particularly in the setting of systemic complications or acute worsening of LM.
Examining the Risk of Cardiovascular Disease in Patients with Psoriasis: A Critical Review
Authors: Papp Kim , Poulin Yves , Vieira Andrew 
Published: March 2015

Background: Increased prevalence of cardiovascular disease (CVD) in psoriasis patients could be due to a greater prevalence of traditional cardiovascular (CV) risk factors or increased inflammatory disease burden. Objective: To critically evaluate evidence on the etiology and magnitude of CV risk in psoriasis patients. Methods: A total of 497 articles were identified for review through a PubMed search using the terms “CVD and psoriasis”; 43 were selected. Data measuring the risk of comorbidities and CV risk factors in psoriasis were retrieved. Results: Psoriasis patients have an increased prevalence of CV risk factors. Evidence suggests an increased risk of CV morbidity and mortality associated with psoriasis itself. Risk estimates vary across studies (OR range 1.13–6.48), possibly due to heterogeneous study design and incomplete data. Conclusion: Although additional data are required, increased awareness of the association of psoriasis with CV risk factors could lead to early diagnosis and treatment of comorbidities, with resultant improvement in morbidity and mortality.
The Pathogenesis of Vitiligo
Authors: Malhotra Neel , Dytoc Marlene 
Published: March 2015

Background: Vitiligo is a commonly encountered pigmentary disorder. Numerous studies and investigations from all over the world have attempted to determine the mechanisms behind this disease; however, the pathogenesis of vitiligo remains elusive. Objective: In this comprehensive review article, we present the findings behind the five overarching theories of what causes this disfiguring and psychologically debilitating disease. Method: We begin our discussion with the role of genetic predisposition and move onward to the neural theory first proposed in the 1950s. Next we discuss the autoimmune hypothesis, followed by the reactive oxygen species model, and conclude by describing the findings of the more recent melanocytorrhagy hypothesis. Conclusion: Although the exact pathogenesis of vitiligo is uncertain, each of these theories likely plays a role. Understanding each theory would pave the way for therapeutic advances for this disease.
Prospective, Randomized, Open-Label Trial Comparing the Safety, Efficacy, and Tolerability of an Acne Treatment Regimen with and without a Probiotic Supplement and Minocycline in Subjects with Mild to Moderate Acne
Authors: Jung Gordon W. , Tse Jennifer E. , Guiha Isabella , Rao Jaggi 
Published: March 2015

Background: Systemic antibiotics are an effective treatment for acne vulgaris. However, intolerable side effects may invariably occur. Objective: To determine whether probiotics reduce the side effects imparted by systemic antibiotics while working synergistically with the latter in treating inflammatory acne. Methods: Forty-five 18- to 35-year-old females were randomly assigned to one of three arms in this prospective, open-label study. Group A received probiotic supplementation, whereas group B received only minocycline. Group C was treated with both probiotic and minocycline. Clinical and subjective assessments were completed at baseline and during the 2-, 4-, 8-, and 12-week follow-up visits. Results: All patients demonstrated a significant improvement in total lesion count 4 weeks after treatment initiation ( p < .001), with continued improvement seen with each subsequent follow-up visit ( p < .01). At the 8- and 12-week follow-up visits, group C had a significant decrease in total lesion count versus groups A ( p < .001) and B ( p < .01). Two patients (13%) from group B failed to complete the study secondary to vaginal candidiasis. Conclusion: Probiotics may be considered a therapeutic option or adjunct for acne vulgaris by providing a synergistic antiinflammatory effect with systemic antibiotics while also reducing potential adverse events secondary to chronic antibiotic use.
Familial Eruptive Syringomas: Case Report and Review of the Literature
Authors: Lau Jenny , Haber Richard M. 
Published: March 2015

Background: Syringomas are benign neoplasms of eccrine origin. A clinical variant is eruptive syringomas, which presents as firm, smooth, yellow to pigmented papules that appear as successive crops on the neck, axillae, chest, abdomen, and/or periumbilical region. To our knowledge, there are only 10 published reports of familial eruptive syringomas. Herein we describe the eleventh report of familial eruptive syringomas, review the literature on this unusual presentation, and suggest a novel classification of familial syringomas based on our literature review. Observations: We report two cases of eruptive syringoma within a family. Eruptive syringomas were widely distributed on the trunk of a healthy 16-year-old female and her 19-year-old brother. Both the 19-year-old man and his mother also had infraorbital syringomas. Conclusion: Familial eruptive syringomas are a rare clinical entity that is likely autosomal dominantly inherited. Future reports of this unusual condition may provide further insight into the etiology of familial syringomas, and genetic analysis of cases may enable the causative gene mutation to be determined.
Radiation- and Chemotherapy-Induced Permanent Alopecia: Case Series
Authors: Haider Mansoor , Hamadah Issam , Almutawa Abdulmonem 
Published: March 2015

Background: Radiation- and chemotherapy-induced alopecia is mostly temporary. However, permanent scalp alopecia is reported, albeit infrequently. Objective: The objective of this observational case series was to determine the kind and doses of chemotherapeutic agents and radiation in inducing permanent alopecia of the scalp. Methods and Results: Eleven patients referred to our department over a period of 3 years for permanent alopecia after chemotherapy/radiotherapy or combination therapy were included. A detailed medical and therapeutic history was obtained from each patient and from medical records. Photography was done, and the scalp biopsies were taken. Patients were divided into three groups according to the type of therapy. The first group received conditioning chemotherapy prior to bone marrow transplantation. The second group had radiation for brain tumors, and the third group received both. Conclusion: A comprehensive multicenter and multidisciplinary study is required to determine the definite causative agents, doses, and other cofactors that induce permanent alopecia following chemotherapy/radiotherapy, as well as the means to avoid this distressing outcome in surviving patients.