ABSTRACT
Acute rheumatic fever (ARF) is an autoimmune response that may occur after infection with group A Streptococcus. Clinical manifestations are protean, making the syndrome difficult to recognize in the 21st century. Secondary prophylaxis with benzathine penicillin is given for 10 years after an episode of ARF to prevent recurrence and reduce the risk of rheumatic heart disease. This case highlights the importance of providing a detailed clinical history to the dermatopathologist when considering ARF in the differential diagnosis.
ABSTRACT
BACKGROUND: Patients often query in regard to cosmetic outcomes after cutaneous surgery. This study provides information on this topic by surveying preference on 2 skin closure methods, purse and linear. The authors used a novel method to poll opinions by incorporating simulated skin within the context of the survey. OBJECTIVE: To determine patient's preference for linear or purse string closure. Additional outcomes were to survey patient's opinions regarding which scar characteristics have the highest cosmetic impact, the cosmetic importance of a scar, and the utility of simulators, and patient photographs as methods of understanding closure techniques. MATERIALS AND METHODS: Participants were prospectively recruited to complete a survey. Data outcomes were analyzed using descriptive statistics and the chi-square test of association. RESULTS: About half of the participants (54.7%) preferred linear closure. Preference was independent of gender (p = .90) or having a prior linear or purse string closure (p = .17). Patient photographs were the most influential for determining preference according to 86.2% of participants; however, 88% of the participants found simulator devices useful for educational purposes. CONCLUSION: The methods in this survey may represent a venue for educating patients and incorporating their preferences into the choices they will make regarding dermatologic procedures, which they will undergo.
Subject(s)
Dermatologic Surgical Procedures/methods , Patient Preference , Suture Techniques , Adolescent , Adult , Aged , Aged, 80 and over , Esthetics , Female , Humans , Male , Middle Aged , Patient Education as Topic , Prospective Studies , Surveys and Questionnaires , SuturesABSTRACT
Giant congenital melanocytic nevi (GCMN) are a rare type of melanocytic nevus that covers a large body surface, often with satellite nevi scattered on the rest of the skin. There are several complications associated with GCMN, including malignant melanoma and neurocutaneous melanosis. The management of GCMN is very complex because of the cosmetic appearance and the associated psychological distress, the risk of severe complications, and the need for long-term follow-up. We report a case of a 43-year-old active-duty female with a GCMN reporting new and symptomatic satellite lesions with atypical features on dermoscopy.
