Subject(s)
Dermatologic Agents/economics , Drug Costs/legislation & jurisprudence , Insurance, Pharmaceutical Services/economics , Pharmaceutical Services/economics , Dermatologic Agents/therapeutic use , Drugs, Generic/economics , Drugs, Generic/therapeutic use , Health Expenditures , Humans , Insurance, Pharmaceutical Services/legislation & jurisprudence , Medicaid/economics , Medicare/economics , Needs Assessment , United States , United States Food and Drug Administration/economics , United States Food and Drug Administration/legislation & jurisprudenceABSTRACT
Cutaneous manifestations of miliary tuberculosis are rare. We report two patients with previously unknown advanced human immunodeficiency virus (HIV) infection, who presented with respiratory collapse and an erythematous papulopustular skin eruption. Skin biopsies demonstrated focal dermal microabscess in one patient, and a subcorneal vesicle with an underlying dermal microabscess in the other. Despite the lack of granulomatous inflammation, acid-fast bacilli (AFB) and Fite stains demonstrated numerous acid-fast bacilli, and Mycobacterium tuberculosis was subsequently isolated in either skin and/or sputum cultures. Pulmonary involvement was present in both cases, but was sufficiently diffuse and atypical so as not to be specific for tuberculosis upon initial clinical and radiographic examination. Our two cases illustrate the importance of careful skin examination in patients with HIV infection, since cutaneous dissemination can be an easily overlooked sign of miliary tuberculosis.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , HIV Infections/complications , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Miliary/diagnosis , AIDS-Related Opportunistic Infections/epidemiology , Adult , Blotting, Western , Enzyme-Linked Immunosorbent Assay , Female , HIV Infections/epidemiology , Humans , Male , Tuberculosis, Cutaneous/epidemiology , Tuberculosis, Miliary/epidemiologySubject(s)
Antimalarials/adverse effects , Drug Eruptions/etiology , Exanthema/chemically induced , Hydroxychloroquine/adverse effects , Skin Diseases, Papulosquamous/chemically induced , Acute Disease , Adult , Diagnosis, Differential , Drug Eruptions/pathology , Exanthema/pathology , Female , Humans , Skin Diseases, Papulosquamous/pathologyABSTRACT
Aneurysms of the facial vasculature have been reported since the mid-seventeenth century from a variety of accidental, violent, and surgical injuries. Of the 386 cases of facial aneurysm reported in the world literature, 327 involve the superficial temporal artery. The nomenclature is somewhat confusing, because pseudoaneurysms are often referred to as simply "aneurysms" in the literature. Given that superficial temporal artery pseudoaneurysms might be seen in the guise of a cyst or lipoma, it is imperative that the dermatologist be aware of their presentation. To date, there have been 7 cases reported in the dermatologic literature. We report 2 additional cases of traumatic superficial temporal artery pseudoaneurysm and review the dermatologic literature.
Subject(s)
Aneurysm, False/diagnosis , Temporal Arteries/injuries , Wounds, Nonpenetrating/diagnosis , Adult , Aneurysm, False/pathology , Aneurysm, False/surgery , Diagnosis, Differential , Forehead , Humans , Male , Temporal Arteries/pathology , Wounds, Nonpenetrating/pathology , Wounds, Nonpenetrating/surgeryABSTRACT
BACKGROUND: Phototherapy is an effective and relatively safe treatment for many skin diseases. Recent concern has focused on an apparent decline in phototherapy usage in the US. OBJECTIVE: To determine the current state of phototherapy as practiced globally. METHODS: Cross-sectional survey of members of the Photomedicine Society. RESULTS: Data derived from responses of 96 members showed all to have been in practice for more than five years, providing phototherapy within two years of completing residency. Usage of narrow-band ultraviolet B, ultraviolet A-1 (UVA-1), bath-psoralens plus UVA, and photodynamic therapy was markedly greater among phototherapists in Europe compared to their counterparts in North America and Asia. CONCLUSIONS: Worldwide, there are fewer younger dermatologists who incorporate phototherapy in their practices. European phototherapists have led the world in usage of the newer phototherapy modalities.
