ABSTRACT
Skin cancer - prevention and therapy Abstract. Skin cancers are increasing in western countries. Prevention consists mainly of primary (UV- protection) and secondary (early detection) prevention. Family physicians are often the first contact persons to evaluate the dignity of skin lesions of high-risk patients and help to perform the diagnosis. If skin cancer is detected early, surgical removal is highly likely to achieve complete cure and reduce the financial burden due to malignant skin tumors. Great progress has been made in the local and systemic therapy of skin tumors in recent years.
Subject(s)
Primary Prevention/methods , Secondary Prevention/methods , Skin Neoplasms , Humans , Skin Neoplasms/prevention & controlABSTRACT
Cogan syndrome and lichen planus represent two autoimmune disorders. Cogan syndrome is a very rare type of ANCA-negative vasculitis affecting the eyes and vestibulocochlear system. It has been associated with other autoimmune disorders, none of them showing any lichenoid inflammation. We herein report the first case of a patient that suffered from Cogan disease and developed isolated lichen planus on all nails a few years after the first diagnosis. The combination of two autoimmune disorders is not unusual and raises the question of common immunogenetic pathomechanisms.
Subject(s)
Antibodies, Monoclonal/administration & dosage , Hidradenitis Suppurativa/drug therapy , Antibodies, Monoclonal, Humanized , Dose-Response Relationship, Drug , Female , Hidradenitis Suppurativa/diagnosis , Humans , Injections, Subcutaneous , Interleukin-1beta , Male , Middle Aged , Severity of Illness Index , Young AdultSubject(s)
Diseases in Twins/diagnosis , Prurigo/diagnosis , Skin/pathology , Twins, Monozygotic , Biopsy , Female , Humans , Young AdultABSTRACT
BRAF inhibitors are broadly used for metastatic melanoma with BRAF mutations. Their use results in various cutaneous side effects, such as the development of keratoacanthomas and squamous cell carcinomas. We report a patient with metastatic melanoma treated with vemurafenib who developed dozens of histologically confirmed epidermal cysts within 2 months after initiation of vemurafenib administration. The cystic lesions were observed only in the localized area where a large exophytic melanoma tumor mass had been previously irradiated. Localized epidermal cysts may constitute an unusual radiation recall reaction in patients treated with BRAF inhibitors.
ABSTRACT
A 23-year-old man with a typical trichilemmal cyst nevus is reported. This recently described disorder is sufficiently characteristic to differentiate it from sebaceous nevus, nevus comedonicus, porokeratotic eccrine nevus, nevus corniculatus, follicular basaloid hamartoma, Munro's nevus and Gardner's syndrome.
Subject(s)
Epidermal Cyst/diagnosis , Facial Neoplasms/diagnosis , Nevus/diagnosis , Skin Neoplasms/diagnosis , Sweat Gland Neoplasms/diagnosis , Dermatologic Agents/therapeutic use , Epidermal Cyst/drug therapy , Epidermal Cyst/pathology , Facial Neoplasms/drug therapy , Facial Neoplasms/pathology , Humans , Isotretinoin/therapeutic use , Male , Nevus/drug therapy , Nevus/pathology , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Sweat Gland Neoplasms/drug therapy , Sweat Gland Neoplasms/pathology , Treatment Outcome , Young AdultABSTRACT
OBJECTIVE: To assess the effect of self-monitoring of blood glucose (SMBG) on glycaemic control in non-insulin treated patients with type 2 diabetes by means of a systematic review and meta-analysis. RESEARCH DESIGN AND METHODS: MEDLINE and the Cochrane Controlled Trials Register were searched from inception to January 2009 for randomised controlled trials comparing SMBG with non-SMBG or more frequent SMBG with less intensive SMBG. Electronic searches were supplemented by manual searching of reference lists and reviews. The comparison of SMBG with non-SMBG was the primary, the comparison of more frequent SMBG with less intensive SMBG the secondary analysis. Stratified analyses were performed to evaluate modifying factors. MAIN OUTCOME MEASURES: The primary endpoint was glycated haemoglobin A(1c) (HbA(1c)), secondary outcomes included fasting glucose and the occurrence of hypoglycaemia. Using random effects models a weighted mean difference (WMD) was calculated for HbA(1c) and a risk ratio (RR) was calculated for hypoglycaemia. Due to considerable heterogeneity, no combined estimate was computed for fasting glucose. RESULTS: Fifteen trials (3270 patients) were included in the analyses. SMBG was associated with a larger reduction in HbA(1c) compared with non-SMBG (WMD -0.31%, 95% confidence interval -0.44 to -0.17). The beneficial effect associated with SMBG was not attenuated over longer follow-up. SMBG significantly increased the probability of detecting a hypoglycaemia (RR 2.10, 1.37 to 3.22). More frequent SMBG did not result in significant changes of HbA(1c) compared with less intensive SMBG (WMD -0.21%, 95% CI -0.57 to 0.15). CONCLUSIONS: SMBG compared with non-SMBG is associated with a significantly improved glycaemic control in non-insulin treated patients with type 2 diabetes. The added value of more frequent SMBG compared with less intensive SMBG remains uncertain.
