"What Is the Role of Field-Directed Therapy in the Treatment of Actinic Keratosis? Part 1: Overview and Investigational Topical Agents"Berman, Brian; Cohen, David E.; Amini, Sadegh
"What Is the Role of Field-Directed Therapy in the Treatment of Actinic Keratosis? Part 2: Commonly Used Field-Directed and Lesion-Directed Therapies"Berman, Brian; Cohen, David E.; Amini, Sadegh
"Combination Therapy With Infliximab and Methotrexate in Recalcitrant Mucocutaneous Behcet Disease"Chan, Wai Ping; Lee, Hyun-Soo
"An Update on the Presence of Psychiatric Comorbidities in Acne Patients, Part 2: Depression, Anxiety, and Suicide"Saitta, Peter; Keehan, Patrick; Yousif, James; Way, Bill V.; Grekin, Steven; Brancaccio, Ronald
Acne vulgaris (AV) is a chronic inflammatory skin disease that affects millions of people. Psychologic disorders such as depression, anxiety, and body dysmorphic disorder are common in patients with AV and the reported prevalence of suicidal ideation and suicide completion in acne patients also is remarkable. Part 1 of this series provided an overview of the prevalence of psychologic disorders in patients with AV Part 2 reviews depression, anxiety, body dysmorphic disorder, and suicidal ideation and completion seen in AV patients. Treatments available for acne patients with coexisting psychiatric illness also are discussed, along with the relationship between oral isotretinoin and depression and suicide. Cutis. 2011;88:92-97.
"Cutaneous manifestations of diabetes mellitus: a case series"Farshchian, Mahmood; Farshchian, Mehdi; Fereydoonnejad, Morteza; Yazdanfar, Ameneh; Kimyai-Asadi, Arash
Diabetes mellitus (DM) is a common disorder with a broad spectrum of cutaneous manifestations. Our purpose was to evaluate the prevalence and main clinical presentation of skin disorders in patients with DM. For a period of 6 months, all of the patients with DM attending the outpatient dermatology and diabetes clinics of the Hamedan University of Medical Sciences, Iran, were clinically examined for cutaneous manifestations of DM. Patients also were evaluated for glycemic control and evidence of other diabetes-related complications. Diabetic skin manifestations were detected in 110 of 155 (71%) patients with DM. The most common skin lesions in both patients with type 1 and type 2 DM were infectious in origin (72%). No statistically significant differences in cutaneous manifestations were observed between the 2 types of DM. In the outpatient population with DM there is a high prevalence of skin lesions mainly represented by cutaneous infections.
"Desquamative inflammatory vaginitis as a manifestation of vitamin D deficiency associated with Crohn disease: case reports and review of the literature"Peacocke, Monica; Djurkinak, Erin; Tsou, Hui C; Thys-Jacobs, Susan
Desquamative inflammatory vaginitis (DIV) is a chronic disorder associated with yellow vaginal discharge, vulvovaginal burning and pruritus, and dyspareunia. The cause of DIV is unknown; however, infectious, hormonal, and inflammatory etiologies have been proposed. In this series, we observe the association of DIV and vitamin D deficiency by reporting 4 cases of women with DIV and vitamin D deficiency associated with Crohn disease. We further show that the DIV symptoms resolve when the circulating concentrations of 25-hydroxyvitamin D (25-HD) returned to normal. These data provide further support for the notion that DIV can be associated with vitamin D deficiency and DIV symptoms reflect altered vaginal mucous membrane function.
"Interstitial granulomatous dermatitis in a patient with rheumatoid arthritis on etanercept" [Letter]Levine, Seth D; Robinson, Maria; Honda, Kord; Nedorost, Susan
"What is your diagnosis? Bullous Sweet's syndrome with neutrophilic alveolitis"Choi, Juliana K; Suh, Ki-Young; Kundu, Roopal V; Wickless, Scott C; Brieva, Joaquin
"Innovations in Natural Antioxidants and Their Role in Dermatology"Ditre, C; Wu, J; Baumann, LS; Rigel, D
The use of natural products for skin care has become more common in the past few years. Consumers are more aware of unnatural chemicals and other toxins and are searching for natural products to use on their skin. Fortunately, a large number of botanical antioxidants exist and are being marketed as either over-the-counter or prescription skin care products. Antioxidants can have profound effects on the intracellular signaling pathways involved in skin damage and thus may be protective against photodamage as well as may prevent wrinkles and inflammation. This supplement discusses the potent effect that botanical antioxidants may have in the management of a broad range of skin issues, from photoaging to inflammatory skin conditions.
"Hereditary basaloid follicular hamartoma syndrome" [Letter]Ackerman, A Bernard
"Common dermatologic disorders in skin of color: a comparative practice survey"Alexis, Andrew F; Sergay, Amanda B; Taylor, Susan C
There is a paucity of data on the epidemiology of dermatologic disease in populations with skin of color. Our objective was to compare the most common diagnoses for which patients of various racial and ethnic groups were treated at a hospital-based dermatology faculty practice. We reviewed the diagnosis codes of 1412 patient visits from August 2004 through July 2005 at the Skin of Color Center at St. Luke's-Roosevelt Hospital Center, in New York. New York, in whom race and ethnicity were recorded. The most common diagnoses observed during dermatologic visits by black and white patients were compared. The leading diagnoses observed during the study period differed between black and white patients. During visits by black patients, the 5 most common diagnoses observed at our center were acne (ICD-9 [International Classification of Diseases, Ninth Revision] 706.1); dyschromia (ICD-9 709.09); contact dermatitis and other eczema, unspecified cause (ICD-9 692.9); alopecia (ICD-9 704.0); and seborrheic dermatitis (ICD-9 690.1). During visits by white patients, the 5 most common diagnoses recorded were acne (ICD-9 706.1); lesion of unspecified behavior (ICD-9 238.2); benign neoplasm of skin of trunk (ICD-9 216.5); contact dermatitis and other eczema, unspecified cause (ICD-9 692.9); and psoriasis (ICD-9 696. 1). Although similarities were seen in the frequency of acne and eczema, conditions such as dyschromia and alopecia were commonly seen during black patient visits but were not among the leading 10 diagnoses made during white patient visits.
"Natural advances in eczema care"Eichenfield, Lawrence F; Fowler, Joseph F Jr; Rigel, Darrell S; Taylor, Susan C
Atopic dermatitis (AD) is a chronic relapsing dermatitis characterized by increased transepidermal water loss (TEWL) and subjective symptoms of pruritus, inflammation, skin sensitivity, and dryness. AD is a frequent issue for individuals of color, though it may be underrecognized. Therapy for AD is based on reducing pruritus and inflammation, and normalizing skin surface lipids, particularly ceramides. Topical corticosteroids are the gold-standard treatment for controlling disease flares, but a variety of active natural ingredients can be used adjunctively to help control itch, inflammation, and dryness. Oatmeal, particularly avenanthramides, a newly discovered oat fraction, may be of particular value in restoring the cutaneous barrier and reducing symptoms of AD. Feverfew, licorice, and dexpanthenol also have been shown to be effective in the management of inflammation. Licorice, which has some skin-lightening activity, may be helpful in patients with postinflammatory hyperpigmentation (PIH). The compromised skin barrier in AD is especially vulnerable to UV radiation exposure. Several new long-lasting photostable sunscreen ingredients provide longer durations of protection with improved cosmetic attributes.
"Etanercept improves psoriatic arthritis patient-reported outcomes: results from EDUCATE"Frankel, Ellen H; Strober, Bruce E; Crowley, Jeffrey J; Fivenson, David P; Woolley, J Michael; Yu, Elaine B; Xia, Hong A; Chiou, Chiun-Fang; Stevens, Seth R
Experience Diagnosing, Understanding Care, and Treatment With Etanercept (EDUCATE) is a multicenter, phase 4, 24-week, open-label study of the safety and efficacy of etanercept therapy in patients with psoriatic arthritis (PsA) in routine dermatologic practice. We present data on patient-reported outcomes (PROs) from EDUCATE, which demonstrate that subjects with PsA achieved clinically meaningful improvements in both skin- and joint-related PROs after 24 weeks of treatment.
"Etiology, classification, and treatment of urticaria"Guldbakke, Kjetil Kristoffer; Khachemoune, Amor
Urticaria is among the most common skin diseases. It can be acute, chronic, mediated by a physical stimulus, or related to contact with an urticant. Some cases result from an underlying small vessel vasculitis. Our understanding of this condition is continuously expanding, and autoimmune mechanisms are now recognized as a cause of chronic urticaria. A search of the PubMed database (US National Library of Medicine) for 'urticaria' yields more than 12,000 results. Our goal is to discuss the current understanding of the etiology, classification, and treatment alternatives. As the topic is comprehensive, our discussion will be limited to a concise review.
"What is your diagnosis? Focal epithelial hyperplasia (Heck disease)"Blyumin, Marianna; Khachemoune, Amor
"Tuberculosis verrucosa cutis presenting as an annular hyperkeratotic plaque"Janjua, SA; Khachemoune, A; Guillen, S
This article has been peer reviewed and approved by Michael Fisher, MD, Professor of Medicine, Albert Einstein College of Medicine. Review date: October 2006. This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Albert Einstein College of Medicine and Quadrant HealthCom, Inc. Albert Einstein College of Medicine is, accredited by the ACCME to provide continuing,medical, education for physicians., Albert Einstein College of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit (TM). Physicians should only claim credit commensurate, with, the extent of their participation in the activity. This activity has been planned and produced in accordance with ACCME Essentials.
"Pemphigus foliaceus: a case report and short review"Khachemoune, Amor; Guldbakke, Kjetil Kristoffer; Ehrsam, Eric
Pemphigus foliaceus (PF) is a rare autoimmune blistering disease presenting in endemic and sporadic forms. The typical presentation is recurrent shallow erosions in a seborrheic distribution. We present a case of a 58-year-old woman with PF who was successfully treated with a combination of oral corticosteroids and dapsone. We also provide a concise review of the literature and discuss the etiology, clinical features, diagnosis, and management of PF.
"Inflammatory linear verrucous epidermal nevus: a case report and short review of the literature"Khachemoune, Amor; Janjua, Shahbaz A; Guldbakke, Kjetil Kristoffer
GOAL: To understand inflammatory linear verrucous epidermal nevus (ILVEN) to better manage patients with the condition. OBJECTIVES: Upon completion of this activity, dermatologists and general practitioners should be able to: 1. Describe the presenting characteristics of ILVEN. 2. Explain the differential diagnosis of ILVEN. 3: Discuss the treatment options for ILVEN.
"What is your diagnosis? Diagnosis: Seabather's eruption"Khachemoune, Arnor; Yalamanchili, Rajesh; Rodriguez, Carlos
"Alefacept in the treatment of recalcitrant palmoplantar and erythrodermic psoriasis"Prossick, Trisha A; Belsito, Donald V
Alefacept is the first biologic agent approved by the US Food and Drug Administration for moderate to severe chronic plaque psoriasis. Prior clinical studies excluded patients with palmoplantar psoriasis or erythroderma. We report 2 patients with recalcitrant psoriasis who responded completely to a full course of alefacept. One patient presented with severe palmoplantar psoriasis recalcitrant to acitretin and methotrexate; another patient presented with erythroderma and was transitioned successfully from cyclosporine A. Alefacept provides another treatment option for palmoplantar and erythrodermic psoriasis and should be considered in the management of patients with these conditions.