Skin cancer in the US Military.

There is an increased risk for melanomas and keratinocyte cancers in those who have served on active duty in the US Military. We believe that an increased exposure to UV radiation, minimal sun-protective strategies, and a paucity of education regarding the risks of UV exposure are primarily responsible for the increased prevalence of skin cancer in this population. Although mitigating these risks is important, it cannot come at the expense of combat effectiveness and military mission readiness. This review proposes education of individual military servicemembers regarding skin cancer prevention and identification, increasing the utilization of sun-protective clothing, and promoting the increased use of sunscreen as measures to decrease the overall risk of cutaneous malignancies in US Military servicemembers.

The ketogenic diet and dermatology: a primer on current literature.

The ketogenic diet has been therapeutically employed from antiquity and is still utilized today in many disease states. With the boom of the complementary and alternative health movement over the last 2 decades, the lay population has grown more interested in disease prevention and treatment via dietary and lifestyle changes and enhancing health and human performance. The ketogenic diet, whether exclusive or intermittent, has been purported by health care professionals and laypersons alike to meet these demands. In this review article, we look to the current literature for proven and possible mechanisms by which ketones and a ketogenic diet may be utilized in the field of dermatology and direct our readers to pursue further research for this promising potential treatment option.

Cholinergic urticaria with anaphylaxis: hazardous duty of a deployed US marine.

Cholinergic urticaria (CU) is triggered by a rise in body temperature and can be complicated by bronchial hyperresponsiveness and anaphylaxis. It primarily affects young adults who actively engage in strenuous exercise, such as servicemen and servicewomen. If the patient reports a history of wheezing or difficulty breathing with urticaria, a water challenge test in a warm bath can be performed to confirm the presence of anaphylaxis. The test should be conducted in an environment in which the patient's airway can be secured and epinephrine can be administered if necessary. Nonsedating antihistamines commonly are used to treat CU, but few other treatments have been thoroughly evaluated for cases that are refractory to antihistamines. We present the case of a 27-year-old US Marine with CU and anaphylaxis confirmed by a water challenge test in a warm bath.

Injuries to the pectoralis major muscle: diagnosis and management.

Injuries to the pectoralis major muscle are relatively infrequent but result in pain, weakness, and deformity of the upper extremity. The usual injury mechanism is during eccentric shortening of the pectoralis major under heavy load, such as when performing a bench press exercise. The ability to detect and treat a pectoralis major rupture is important for both the clinician and the patient and is aided with knowledge of the anatomy, the clinical findings, and results of nonoperative and operative care. It is important to understand the physical demands and desires of the patient as well as to understand the outcomes of both nonoperative and operative care to make an informed decision regarding optimal treatment. This article highlights the importance of the clinical examination in identifying the injury, examines various surgical techniques to repair the rupture, and reports on potential complication and reinjury rates.