ABSTRACT
We performed a cross-sectional study of Hispanic and non-Hispanic parents of children with acne using a survey designed to determine their level of awareness of acne and its treatment; 82% of Hispanic parents and 40% of non-Hispanic parents agreed that a health care provider should treat mild acne (p < 0.001). Hispanic parents of adolescents with acne agreed more frequently than non-Hispanic parents that children with mild and moderate acne should be taken to a health care provider for treatment, but they tended not to visit health care providers. Future studies should aim to determine the reasons for this discrepancy, after which culturally sensitive educational programs can be developed to address this disparity.
Subject(s)
Acne Vulgaris , Health Knowledge, Attitudes, Practice , Hispanic or Latino/psychology , Parents/psychology , Acne Vulgaris/diagnosis , Acne Vulgaris/ethnology , Acne Vulgaris/therapy , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle AgedABSTRACT
Vemurafenib, a BRAF inhibitor, is FDA-approved for the treatment of metastatic melanoma in patients who harbor the BRAF V600E mutation. By inhibiting BRAF, vemurafenib prevents the mitogen-activated protein kinase (MAPK) pathway from driving melanoma growth. Here we present a patient with paradoxical activation of the MAPK pathway by vemurafenib, ultimately resulting in deleterious cutaneous manifestations. An emphasis on close follow-up is warranted for new or changing lesions for patients on this medication and other BRAF inhibitors.
Subject(s)
Indoles/therapeutic use , Melanoma/drug therapy , Skin Neoplasms/drug therapy , Sulfonamides/therapeutic use , Antineoplastic Agents/adverse effects , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Female , Humans , Indoles/adverse effects , Indoles/pharmacology , Melanoma/genetics , Melanoma/pathology , Middle Aged , Mitogen-Activated Protein Kinases/metabolism , Neoplasm Metastasis , Protein Kinase Inhibitors/adverse effects , Protein Kinase Inhibitors/pharmacology , Protein Kinase Inhibitors/therapeutic use , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Proto-Oncogene Proteins B-raf/genetics , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Sulfonamides/adverse effects , Sulfonamides/pharmacology , VemurafenibABSTRACT
A 59-year-old HIV-positive, hepatitis C positive man on highly active antiretroviral therapy presented with a 2-year history of extreme swelling of the lower lip. Granulomatous cheilitis was diagnosed.
Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections/complications , HIV Infections/drug therapy , Melkersson-Rosenthal Syndrome/complications , Melkersson-Rosenthal Syndrome/diagnosis , Hepatitis C/complications , Humans , Lip/pathology , Male , Melkersson-Rosenthal Syndrome/pathology , Middle AgedABSTRACT
BACKGROUND: There are no validated outcome measures for postinflammatory hyperpigmentation (PIH). OBJECTIVE: We sought to determine the reliability and validity of an outcome measure for PIH after acne in patients with skin of color. METHODS: A postacne hyperpigmentation index (PAHPI) was developed. Six raters scored 21 patients with PIH twice. Reliability was determined within and between raters, whereas validity was evaluated by comparing scores with severity ranking by an independent dermatologist. The pigment intensity scores were compared with the melanin index of each patient using a narrowband reflectance spectrophotometer. A quality-of-life score (Skindex-29) was also compared with PAHPI scores. RESULTS: Total PAHPI scores showed good reliability within and between raters and were valid when compared with clinical severity and melanin indices. Good correlation was achieved between the total PAHPI score and the emotion subscale of the Skindex-29. LIMITATIONS: Generalizability of results is limited to African American females. CONCLUSION: The PAHPI shows good reliability and validity when scored on patients with PIH from acne vulgaris. The PAHPI also correlates well with the emotional impact of PIH as measured by the Skindex-29. Future studies should assess the ability of the PAHPI to change with improvement of PIH from acne after treatment.
Subject(s)
Acne Vulgaris/complications , Hyperpigmentation/etiology , Hyperpigmentation/pathology , Severity of Illness Index , Acne Vulgaris/pathology , Adolescent , Adult , Black or African American , Asian People , Dermatitis/pathology , Female , Hispanic or Latino , Humans , Hyperpigmentation/psychology , Male , Melanins/analysis , Observer Variation , Quality of Life , Reproducibility of Results , Spectrophotometry , Young AdultSubject(s)
Melanosis/drug therapy , Plant Extracts/pharmacology , Polypodium/chemistry , Sunscreening Agents/therapeutic use , Administration, Cutaneous , Administration, Oral , Double-Blind Method , Female , Hispanic or Latino , Humans , Plant Extracts/administration & dosage , Plant Extracts/adverse effects , Treatment OutcomeABSTRACT
Yellow plaques and papules on the skin are hallmarks of xanthomas. These are not always associated with abnormalities in lipid profiles or their associated proteins. In cases of diffuse normolipemic plane xanthomas these cutaneous findings are often associated with myelodyscrasias including monoclonal gammopathy of unknown significance and multiple myeloma. Such clinical presentations may indicate that an evaluation for myelodyscrasias is warranted.
