"Doctor, do i need a skin check?"

Total-body skin examination (TBSE) is the bedrock on which most general dermatologists' clinic days are built. Primarily performed for all-cause skin cancer detection and prevention, the clinical data gained and advice imparted during the patient visit disseminate safety guidelines and behavioral patterns that can shape a community's approach to its risk factors and screening practices. Nonetheless, TBSE technique, frequency, and data-driven evidence of improvement in population morbidity and mortality comprise ongoing debate. When a patient asks, "Do I need a skin check?", the answer is more complicated than one might imagine. For now, each clinician who screens for skin cancer must optimize the face-to-face opportunities with the patient to view as much as we can as often as clinically prudent. As said by Philip Roth, "Seeing is believing and believing is knowing and knowing beats unknowing and the unknown." Recommendations are provided here for clinicians to address the clinical utility of the screening practices we adopt every day.

Scabies.

Scabies infestation in humans is a complex interplay between mite, host, and host environment. New techniques for diagnosis, treatment, and eradication are constantly in flux due to varying presentations of scabetic eruptions, a dearth of especially sensitive and specific measures for diagnosis, resistances to pharmacologic therapy, and disparate regional resources. This review will provide an update on the clinical variations, detection methods, and management options.

Peroxisome proliferator-activated receptors increase human sebum production.

Sebum production is key in the pathophysiology of acne, an extremely common condition, which when severe, may require treatment with isotretinoin, a known teratogen. Apart from isotretinoin and hormonal therapy, no agents are available to reduce sebum. Increasing our understanding of the regulation of sebum production is a milestone in identifying alternative therapeutic targets. Studies in sebocytes and human sebaceous glands indicate that agonists of peroxisome proliferator-activated receptors (PPARs) alter sebaceous lipid production. The goal of this study is to verify the expression and activity of PPARs in human skin and SEB-1 sebocytes and to assess the effects of PPAR ligands on sebum production in patients. To investigate the contribution of each receptor subtype to sebum production, lipogenesis assays were performed in SEB-1 sebocytes that were treated with PPAR ligands and isotretinoin. Isotretinoin significantly decreased lipogenesis, while the PPARalpha agonist-GW7647, PPARdelta agonist-GW0742, PPARalpha/delta agonist-GW2433, PPARgamma agonist rosiglitazone, and the pan-agonist-GW4148, increased lipogenesis. Patients treated with thiazolidinediones or fibrates had significant increases in sebum production (37 and 77%, respectively) when compared to age-, disease-, and sex-matched controls. These data indicate that PPARs play a role in regulating sebum production and that selective modulation of their activity may represent a novel therapeutic strategy for the treatment of acne.