Aminolevulinic acid photodynamic therapy for skin cancers.

Aminolevulinic acid photodynamic therapy (ALA-PDT) is an effective and noninvasive therapy for superficial basal cell carcinoma (BCC) and Bowen's disease. It also may have a role in the treatment of nodular BCC and other cutaneous malignancies, including localized cutaneous lymphomas. ALA-PDT offers multiple advantages over traditional treatments, including little to no scarring, excellent cosmetic results, and the ability to treat multiple lesions simultaneously. It is not an effective therapy for aggressive subtypes of BCC or for invasive squamous cell carcinoma. Finally, ALA-PDT may be a useful way to prevent new skin cancers in certain high-risk patients.

Treatment of postoperative soft tissue loss with injectable poly-L-lactic acid.

We present a case of a 40-year-old woman with a history of a wide local excision for a melanoma and subsequent postoperative soft tissue loss who was successfully treated with injectable poly-L-lactic acid (Sculptra). After only one treatment with the filler agent, the treated area showed significant volume enhancement and improved cosmesis 10 months postinjection. We propose a possible role for injectable poly-L-lactic acid in improving the appearance of postoperative volume loss.

Antiphospholipid syndrome: a review and update for the dermatologist.

Antiphospholipid syndrome (APS) is a hypercoagulable disorder that results in vascular thrombosis. The symptoms are numerous and depend on the size and location of the vessels involved. Patients with this condition can have significant morbidity and occasionally mortality. It is important for dermatologists to be knowledgeable about APS because a large percentage of patients with this condition will present with dermatologic manifestations. If diagnosed and treated early, patients can be spared the consequences of this serious disease.

Generalized essential telangiectasia: a case report and review of the literature.

Generalized essential telangiectasia (GET) is a well-established but seldom reported disorder. Patients with this condition develop widespread telangiectasias for no known reason. Although the condition can be cosmetically and psychologically devastating, it fortunately is not associated with other diseases or complications. Treatment can be difficult and expensive, but the therapeutic benefit of providing patients with a name and prognosis for their disease cannot be overemphasized.

Health service utilization by Alzheimer's disease patients: a 2-year follow-up of primary versus subspecialty care.

All dementia patients and their caregivers who had received a university-based comprehensive evaluation and a diagnosis of Alzheimer's disease during 1997 (N = 80) were identified. Of the original cohort, 48.8% (n = 39) were able to be contacted approximately 2 years after their initial assessment, and the caregivers were the informants for this follow-up. Two subgroups were defined: 22 patients were being seen only by their primary care physicians (MED), while 17 patients were also being treated by a geriatric psychiatry faculty member (GERO). There were statistically significant differences between the 2 groups (MED versus GERO, respectively) at follow-up in terms of (1) institutionalization (30.0% versus 4.6%, P < .05), (2) CDR (2.3 versus 1.5, P < .005), and (3) prescription of donepezil at follow-up (45.5% versus 76.5%, P = .05). These differences are being assessed in a larger scale prospective study.