Laser earlobe revision.

BACKGROUND: Earlobe tears and disfigurement often result from prolonged pierced earring use and trauma. They are a common cosmetic complaint for which surgical reconstruction has often been advocated. MATERIALS AND METHODS: A series of 10 patients with earlobe tears or disfigurement treated using straight-line closure, carbon dioxide (CO2 ) laser ablation, or both are described. A succinct literature review of torn earlobe repair is provided. RESULTS: Successful repair with excellent cosmesis of torn and disfigured earlobes was obtained after straight-line surgical closure, CO2 laser ablation, or both. CONCLUSION: A minimally invasive earlobe repair technique that involves concomitant surgical closure and CO2 laser skin vaporization produces excellent cosmetic results for torn or disfigured earlobes.

Diaper dermatitis: a review and update.

PURPOSE OF REVIEW: Diaper dermatitis is the most common cutaneous diagnosis in infants. In this review, common causes of diaper dermatitis and similarly presenting conditions will be covered, as well as updates on treatments of common diaper dermatitides. RECENT FINDINGS: There have been recent advancements in the treatment of diaper dermatitis. In addition, there are many newly recognized causes of diaper dermatitis that clinicians should be aware of. SUMMARY: Irritant dermatitis is the most common cause of diaper dermatitis. However, there are multiple other common causes of diaper dermatitis and it is thus imperative that the clinician be aware of cutaneous mimickers of irritant diaper dermatitis as well as their treatments.

Cultural practices affecting the skin of children.

PURPOSE OF REVIEW: Cultural practices that present with dermatologic manifestations in the pediatric population are common. However, such skin manifestations are often poorly understood in western medicine and lesions are misdiagnosed, with child abuse being a common misdiagnosis. RECENT FINDINGS: The 2000 Census counted approximately 28 million first-generation immigrants in the United States. As populations are increasing in diversity, there are an increasing number of physical presentations from diverse cultural practices. Physicians will begin to encounter skin findings that they may have never seen before. It is, therefore, imperative for physicians to be aware of such cultural practices and the cutaneous findings associated with them. SUMMARY: Numerous cultural practices may present with skin manifestations in children. It is, therefore, important for pediatricians to be aware of such practices and their associated skin lesions for proper diagnosis and management. Various cultural practices with cutaneous findings will be covered in this article.

Viremia in acute herpes zoster.

BACKGROUND: A phase 2 trial was conducted to evaluate the efficacy of a topical antiviral, sorivudine, as an adjuvant to valacyclovir for the treatment of acute herpes zoster. METHODS: In this randomized, placebo-controlled, double-blind trial, 25 patients were treated with either sorivudine or placebo cream. All patients began 7 days of valacyclovir treatment on day 3. Zoster lesion swab samples and samples of peripheral blood mononuclear cells were collected periodically throughout the study and were analyzed for varicella-zoster virus (VZV) DNA by use of both qualitative and real-time polymerase chain reaction. Serum samples collected periodically throughout the study were analyzed for VZV DNA by use of real-time polymerase chain reaction. RESULTS: VZV DNA was detected in all 3 sample types, and the number of viral copies correlated with the progression of herpes zoster. No statistically significant differences were seen between the placebo- and sorivudine-treated groups with respect to clinical characteristics or laboratory test results. CONCLUSION: The detection of VZV DNA in the serum and peripheral blood mononuclear cells of all 25 zoster patients documents that viremia is a common manifestation of herpes zoster. Sorivudine cream appears to be a safe and well-tolerated adjuvant therapy; however, further phase 2 studies are needed to determine its clinical efficacy for the treatment of herpes zoster. Trials registration. ClinicalTrials.gov identifier: NCT00652184.

Varicella zoster vaccines.

In the past, the varicella zoster virus affected virtually the entire population and had substantial morbidity and mortality associated with both primary varicella and herpes zoster reactivation. Since the varicella vaccine was first approved in 1995, there has been a significant decline in incidence, morbidity, and mortality caused by primary varicella. Breakthrough disease with the one-dose vaccine schedule led to the recommendation in 2006 that children receive a two-dose vaccine series. Older adults have also benefited from the development of the zoster vaccine. In 2006, the Food and Drug Administration approved the zoster vaccine, a higher concentration of the same live attenuated virus used in the primary varicella vaccine, for persons 60 years of age or older. It has the potential to help millions of people avoid the pain associated with reactivation of the varicella zoster virus by reducing the incidence and severity of herpes zoster and postherpetic neuralgia.

Human papillomavirus vaccines.

Cervical and other cancers linked to the human papillomavirus (HPV) are a cause of significant morbidity and mortality. Since the discovery of HPV as a cause of these cancers, there has been much research and development in the field of HPV vaccination. Two current prophylactic vaccines have proved highly effective in preventing disease because of the vaccine types. Recent advances in prophylactic and therapeutic vaccines are discussed.

Existing antiviral vaccines.

The innovation of vaccines has allowed for one of the greatest advancements in the history of public health. The first of the vaccines have been the antiviral vaccines, in particular the smallpox vaccine that was first developed by Edward Jenner in 1796. This article will review vaccination for the following viral diseases: measles, mumps, rubella, polio, hepatitis A, hepatitis B, influenza, rotavirus, rabies, monkeypox, smallpox, Japanese encephalitis, and yellow fever.

Existing antibacterial vaccines.

There are countless bacterial pathogens that cause disease in humans. Many of these bacterial infections not only cause significant morbidity and mortality in the human population but also cause a significant economic impact on society. Vaccines allow for reduction and potential eradication of such diseases. This article will review the currently approved antibacterial vaccines, which are vaccines for pertussis, tetanus, diphtheria, meningococcus, pneumococcus, Haemophilus influenza, cholera, typhoid, and anthrax.

HIV vaccines under study.

Human immunodeficiency virus (HIV) infection is a worldwide epidemic, with over 42 million people currently infected. Since the discovery of HIV as the causative agent of the acquired immune deficiency syndrome (AIDS), many potential vaccines have been created. The first of these vaccines presented disappointing results; however, that has not deterred researchers from continuing to develop more potential HIV vaccines. This article will review the various current HIV vaccine candidates under study.