Perifolliculitis mimicking basal cell carcinoma.

We present a case of a periocular painless perifolliculitis clinically mimicking basal cell carcinoma (BCC), excised by margin-controlled excision. This case reminds readers that perifolliculitis as a response to rosacea can mimic BCC. The value of diagnostic biopsy and dermoscopy to support management planning and avoid unnecessary surgery is discussed.

Neo-adjuvant Vismodegib followed by radiation in locally advanced basal cell carcinoma.

Basal cell carcinomas occur in up to 39% of Caucasian men and 28% of women. Rarely it can present a management dilemma in patients with neglected locally advanced disease of large dimension or involvement of critical structures. The Hedgehog pathway is constitutively active in almost all basal cell carcinomas and patients with Naevoid Basal Cell Carcinoma Syndrome have germline mutations in the Patched tumor suppressor gene, a Hedgehog pathway component, on chromosome 9q. This case describes an elderly patient with an untreated sporadic Basal cell carcinoma whose dimensions precluded local management approaches. The Hedgehog pathway inhibitor Vismodegib had a dramatic response allowing definitive treatment to be pursued.

Itchy lesions in pigmented skin.

A 37-year-old woman with type VI skin presented with 1-year history of pruritic lesions affecting her arms, chest and legs. The lesions were approximately 5 mm in diameter, annular and with a raised border. A skin biopsy was performed which showed a diagnosis of disseminated superficial actinic porokeratosis. Porokeratosis is an unusual presentation in pigmented skin and there are very limited reports of this occurrence in the literature.

Mumps and the media: changes in the reporting of mumps in response to newspaper coverage.

OBJECTIVE: To determine the links between national newspaper coverage of mumps after a press release and increased reports of clinical mumps cases. DESIGN AND SETTING: A cross sectional study involving people aged 15-24 years in the West Midlands, and England and Wales. Reported mumps cases were obtained from statutory notifications of infectious diseases to the Health Protection Agency and reports to the Royal College of General Practitioners Weekly Returns Service. Data on newspaper coverage was obtained by retrospectively reviewing the Health Protection Agency press archives. MAIN OUTCOME MEASURE: The effect of newspaper coverage was assessed by examining the 4 weeks before the press release (weeks 15-18 of the year), a 2-week period that included the week of the press release (weeks 19-20) and 4 weeks after the press release (weeks 21-24). MAIN RESULTS: Mumps notification rates were declining before increased newspaper coverage. Significant increases in national (from 28.3/100 000 population (95% CI 26.5 to 30.1) in weeks 18 to 42.8 (95% CI 40.6 to 45) in week 20) and local (from 9.8 (95% CI 7.4 to 12.1) to 21.2 (95% CI 17.7 to 24.6)) notification rates were seen after increased newspaper coverage. Reports rapidly declined after decreased media interest. CONCLUSIONS: The reported incidence rate of mumps seems to be markedly influenced by the level of newspaper coverage. This has implications for surveillance activities.

The second trimester genetic sonogram.

The genetic sonogram, a fetal anatomic survey targeted at identifying features associated with aneuploidy, is carried out between 15 and 20 weeks' gestation. It has evolved as an adjunctive screening tool capable of further refining the individualized risk-calculation for trisomy that is based on maternal age or serum screening markers. The significance of a range of major structural anomalies and so-called "soft-markers" for trisomy, detected both in isolation and in combination, has been widely investigated. This review serves to describe the key components of the second trimester genetic sonogram and to illustrate how these markers are integrated into risk assessment for aneuploidy.