Subject(s)
Complementary Therapies/statistics & numerical data , Dermatology , Outpatients/statistics & numerical data , Primary Health Care , Adult , Aged , Educational Status , Ethnicity/statistics & numerical data , Female , Health Care Surveys , Humans , Male , Middle Aged , Skin Diseases/therapyABSTRACT
Eccrine porocarcinoma (EP) is a rare malignant tumor arising from the intraepidermal sweat duct. The lesions have a varied clinical appearance and usually are asymptomatic. In reported cases, metastasis is rare but can be devastating when it occurs. We describe an unusual case of EP in a patient who presented with metastatic disease. New-onset exquisite pain prompted his evaluation. This case and review of metastatic disease is presented to raise awareness of this tumor, its varied clinical presentations, differential diagnosis, and management.
Subject(s)
Eccrine Porocarcinoma/diagnosis , Pain/etiology , Sweat Gland Neoplasms/diagnosis , Aged, 80 and over , Diagnosis, Differential , Eccrine Porocarcinoma/pathology , Follow-Up Studies , Humans , Male , Neoplasm Metastasis , Sweat Gland Neoplasms/pathologyABSTRACT
Atopic dermatitis is a chronic inflammatory skin disease that disrupts the daily work and social lives of patients. Treatment of atopic dermatitis makes use of a variety of therapies, from medications to nutritional supplements to psychotherapy. Health outcomes research evaluates the efficacy, safety, and impact on health-related quality of life of these therapies.
Subject(s)
Delivery of Health Care , Dermatitis, Atopic/epidemiology , Dermatitis, Atopic/therapy , Dermatology , Outcome Assessment, Health Care , Dermatitis, Atopic/etiology , Humans , United StatesABSTRACT
Giant congenital melanocytic nevi (GCMN) are rare lesions that are present in 1 in every 20,000 new births. A 10-year review of all patients treated at a pediatric burn center was performed with the goal of identifying the characteristics of patients with GCMN and the outcomes of the treatment provided in a burn center. Thirty-six patients met the definition of GCMN; 64% were female and 36% were male. The most common ethnicity was white (47%), followed by Latino (19%). Most patients were between the ages of 1 and 10 years at the time of their first procedure (64%), and the mean age of patients at the time of their first procedure was 7 years. Eighty-nine percent had only one lesion. The most common location of lesions was the face (64%), followed by the scalp (17%) and back (17%). Seventy-four percent of the samples sent to pathology were congenital compound melanocytic nevi, and 20% were congenital intradermal melanocytic nevi. None of the lesions contained malignant changes at the time of the pathological examination. The various treatment modalities provided in the burn unit are reviewed. The authors conclude that the burn unit is an ideal setting for the treatment of GCMN.
Subject(s)
Nevus, Pigmented/congenital , Nevus, Pigmented/therapy , Skin Neoplasms/congenital , Skin Neoplasms/therapy , Burn Units , Child , Child, Preschool , Female , Humans , Infant , Male , Nevus, Pigmented/pathology , Retrospective Studies , Skin Neoplasms/pathologyABSTRACT
BACKGROUND: Psoriasis is associated with several extracutaneous manifestations of which ocular complications are common. Signs and symptoms of ocular psoriasis may be subtle and overlooked. The dermatologic literature has generally underaddressed these complications; however, a thorough understanding of ophthalmic involvement is important to the comprehensive care of patients with psoriasis. OBJECTIVE: We sought to provide a complete and up-to-date clinical guide on the manifestations and diagnostic considerations of ocular psoriasis. METHODS: PubMed and Google Scholar were used to find primary resources. The MeSH database of PubMed was used to link key ocular terms with the words "psoriasis," "psoriatic arthritis," and/or various psoriasis medications. RESULTS: Ocular manifestations of psoriasis are discussed anatomically to allow for easy clinical reference. Complications include direct cutaneous effects such as eyelid involvement and blepharitis, and immune-mediated conditions such as uveitis. LIMITATIONS: Literature reviewed was primarily focused on English-language journals. In addition, older articles not included in the above electronic databases were underrepresented. CONCLUSION: Ophthalmic complications of psoriasis are numerous and affect almost any part of the eye; however, they may be easily missed. Physicians should maintain a high index of suspicion that ophthalmic symptoms in patients with psoriasis may be related to their underlying disease, even though signs and symptoms are often vague. Screening and evaluation guidelines for ocular disease should be more clearly incorporated into the already large academic framework of psoriasis research and care.
Subject(s)
Eye Diseases/diagnosis , Eye Diseases/etiology , Psoriasis/complications , HumansABSTRACT
BACKGROUND: A number of disease-severity and quality-of-life (QoL) instruments have emerged in atopic dermatitis (AD) in the last decade. OBJECTIVES: To identify trends in outcomes instruments used in AD clinical trials and to provide a useful summary of the dimensions and validation studies for the most commonly used measures. METHOD: All randomized control trials (RCTs) from 1985 to 2010 in the treatment of AD were examined. RESULTS: Among the 791 RCTs reviewed, we identified 20 disease-severity and 14 QoL instruments. Of these outcomes instruments, few have been validated. SCORAD, EASI, IGA and SASSAD were the most commonly used disease-severity instruments and CDLQI, DFI, DLQI and IDQOL were the most frequently used QoL measures. LIMITATIONS: The small number of RCTs using QoL scales makes identifying trends for QoL instruments difficult. CONCLUSION: Overall, there is an increase in the use of disease-severity and QoL instruments in AD clinical trials.
Subject(s)
Dermatitis, Atopic/therapy , Quality of Life , Severity of Illness Index , Treatment Outcome , Humans , Infant , Randomized Controlled Trials as TopicABSTRACT
CONTEXT: The absorption of vapors through the skin is an important issue because exposure of skin to chemicals in the ambient air occurs at all times. In regards to occupational health, accurately quantifying percutaneous absorption is crucial for worker health and safety. OBJECTIVE: Review the available data regarding the percutaneous absorption of vapors in humans. METHODS: We conducted a systematic search in Scopus(®) and PubMed using keywords "vapor" and "percutaneous absorption" up until September 23, 2010. RESULTS: Eleven articles document the absorption of vapors in human skin in vivo. Seven articles utilized aromatic solvents including xylene and toluene, two tested 2-methoxyethanol, and two tested solely 2-butoxyethanol. Of the 11 articles, eight estimated the percentage of skin absorption compared with whole body exposure. Of the eight articles, four concluded that percutaneous absorption of aromatic solvent vapors from the air is likely to be insignificant and four concluded that dermal uptake of alcohol solvents caused significant absorption. CONCLUSION: Skin absorption of vapors is an important and relevant topic that has not been studied extensively. Further investigation of percutaneous vapor absorption is needed to ensure safe usage of solvent vapors in the workplace, and possibly elsewhere.
