A verrucous plaque of the eyebrow.

Phaeohyphomycosis is a rare dematiaceous fungal infection requiring surgical excision or appropriate systemic antifungal therapy. The objective of this study is to report a case of phaeohyphomycosis of the right eyebrow successfully treated with surgical excision. We performed an excision of a dermal plaque of phaeohyphomycosis using 4-mm margins on the right brow extending onto the right forehead. An island pedicle flap was used to close the defect. Histopathologic evaluation confirmed the presence of numerous dematiaceous fungal organisms fully consistent with phaeohyphomycosis, and the margins were verified to be free of fungal organisms. Culture of a central portion of the excised lesion confirmed that the causative organism was a saprophytic fungus. Adjuvant systemic antifungal therapy was offered to the patient, but because of financial resources, the patient did not desire any further treatment. The patient remains free of the organism and has healed well, without complications. Phaeohyphomycosis can be effectively treated with excision alone, and when located in a risky anatomic location, such as near the orbit, adjuvant treatment with systemic antifungals may be warranted to prevent recurrence.

Lower extremity lymphedema update: pathophysiology, diagnosis, and treatment guidelines.

Lower extremity lymphedema is an important medical issue which causes morbidity and is frequently seen by dermatologists. The subject has not been adequately addressed in dermatologic literature for many years. Primary lymphedema is caused by an inherent malfunction of the lymph-carrying channel, in which no direct outside cause can be found. Secondary lymphedema is caused by an outside force, such as tumors, scar tissue after radiation, or removal of lymph nodes, which results in dysfunction of the lymph-carrying channels. Treatment is based on rerouting the lymph fluid through remaining functional lymph vessels. This is accomplished through elevation, exercises, compression garments/devices, manual lymph drainage, and treatment is combined with good skin care practices.

Social sensitivity and acne: the role of personality in negative social consequences and quality of life.

BACKGROUND: Acne affects a majority of adolescents and a substantial number of adults. The adverse social impact of acne is well documented. Negative social consequences, however, are likely to be determined by personality features as well as acne severity. PURPOSE: To determine whether a personality trait--dispositional social sensitivity--is associated with the adverse social impact of acne. METHODS: A survey of 479 acne sufferers between the ages of 16 and 62 was conducted in the Piedmont region of North Carolina, United States. Respondents were classified as either high or low social sensitivity and compared on demographic, disease characteristics, and quality of life. Main and interaction effects were evaluated for acne severity and social sensitivity in relation to global and intimate social concerns and social interference. RESULTS: Greater acne severity was significantly associated with poorer social outcomes and quality of life (ps < 0.05). For women, higher social sensitivity was independently associated with poorer outcomes (ps < 0.05), while for men, higher social sensitivity interacted with acne severity and was associated with worse social outcomes and life quality (ps < 0.05). CONCLUSIONS: Acne is a biopsychosocial skin condition. Dispositional social sensitivity is an independent psychological factor associated with poorer social functioning and quality of life. Treatment of the acne patient should consider psychosocial factors as well as biological factors.