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Emergency Department Diagnosis and Management of Skin Diseases With Real-Time Teledermatologic Expertise

from ArchDerm - 01 Jul 14

ImportanceSkin conditions are a common reason for patients to consult emergency department (ED) physicians.ObjectiveTo evaluate real-time teledermatologic expertise with the use of mobile telephones for the diagnosis and management of skin conditions in patients seen in the ED.Design, Setting, and ParticipantsThis observational study of adults who consecutively consulted in the ED for a dermatologic condition was conducted under routine conditions in the ED from May 1, 2008, through June 30, 201



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Effects of Low-Dose Recombinant Interleukin 2 to Promote T-Regulatory Cells in Alopecia Areata

from ArchDerm - 01 Jul 14

ImportanceAn impaired inhibitory function of circulating CD4+CD25+ regulatory T (Treg) cells was reported to play a key role in alopecia areata (AA). We report the first use to our knowledge of low-dose interleukin 2 for treating severe AA by promoting the recruitment of Treg cells.ObservationsWe conducted a prospective open pilot study in 5 patients with severe AA resistant to previous systemic treatments. Subcutaneous interleukin 2 (1.5 million IU/d) was administered during 5 days, followed by



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Corticosteroid-Induced Meningococcal Meningitis in a Patient With Chronic Meningococcemia

from ArchDerm - 01 Jul 14

ImportanceAlthough chronic meningococcemia is an uncommon disorder, it is of great importance to clinicians across multiple disciplines because it presents similarly to reactive, neoplastic, or rheumatic disorders. Ruling out chronic meningococcemia, however, represents a diagnostic challenge because routine microbiological investigations frequently fail to identify Neisseria meningitidis. Although treatment with corticosteroids might be helpful in various conditions, corticosteroid treatment ma



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Widespread Morbilliform Eruption Associated With Telaprevir Use of Dermatologic Consultation to Increase Tolerability

from ArchDerm - 01 Jul 14

ImportanceTelaprevir, combined with pegylated interferon alfa and ribavirin, is an efficacious approach to treat hepatitis C virus infection. A morbilliform eruption associated with telaprevir is a common adverse effect experienced by patients. Current guidelines mandate telaprevir discontinuation in any patient with a severe, progressive, or unresponsive cutaneous eruption.ObservationsEight patients with a grade 3 (severe) widespread morbilliform eruption associated with telaprevir were referre



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Oral Pigmentation in McCune-Albright Syndrome

from ArchDerm - 01 Jul 14

ImportanceThe differential diagnosis for oral lentigines includes several syndromes with important associated systemic findings. McCune-Albright syndrome (MAS), a mosaic condition associated with café au lait pigmentation, is not typically considered a mucosal lentiginosis syndrome. The clinical phenotype of MAS is variable because of mosaicism, but oral pigmentation developing in mid-childhood to early adulthood should be recognized as a clinical feature of MAS.ObservationsWe present 4 patients








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Further Investigation Into the Risk of Skin Cancer Associated With the Use of UV Nail Lamps

from ArchDerm - 01 Jul 14

Use of UV radiation in nail salons for drying and curing polishes has come under scrutiny owing to concerns for carcinogenesis. A few recent studies evaluated potential irradiation scenarios and concluded that UV nail polish drying lamps pose only a small risk to clients. However, these studies lacked randomized light sampling from commercial salons.



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Alemtuzumab Therapy for Leukemic Cutaneous T-Cell Lymphoma Diffuse Erythema as a Positive Predictor of Complete Remission

from ArchDerm - 01 Jul 14

Low-dose alemtuzumab (LDA) therapy is highly effective and generally well tolerated for refractory cutaneous T-cell lymphoma (CTCL) with peripheral blood disease. Treatment with LDA is effective in patients with blood involvement (leukemic disease) but ineffective in mycosis fungoides (MF), reflecting the fact that these lymphomas derive from distinct T-cell subsets. Malignant T cells in patients with blood disease have the phenotype of CCR7+/L-selectin+ central memory cells (TCM) (migratory cel



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Compression of Venous Ulcers Standardizing Standard Care

from ArchDerm - 01 Jul 14

Venous leg ulcers (VLUs) are common, affecting upward of 1% of adults and with increasing incidence and prevalence with advancing age. Venous leg ulcers are associated with reduced quality of life and significant health care costs in addition to sustained ambulatory venous pressure (venous hypertension), which most often results from thrombosis and/or valve disease, affecting the superficial, perforator, or deep veins. As a result, calf muscle pump dysfunction ensues, leading to ulcer formation.



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True Leukonychia in Crohn Disease Induced by Selenium Deficiency

from ArchDerm - 01 Jul 14

Leukonychia is divided into 2 major types: true leukonychia, which involves the nail plate, and apparent leukonychia, which involves the nail bed. Herein, we present the first case to our knowledge of true leukonychia successfully treated with selenium substitution.



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Hydroxyurea-Induced Leg Ulceration in a Patient With a Homozygous MTHFR Polymorphism Misdiagnosed as Pyoderma Gangrenosum

from ArchDerm - 01 Jul 14

Both hydroxyurea, an antimetabolite used to treat chronic myeloproliferative diseases, and methylene tetrahydrofolate reductase (MTHFR) polymorphisms have been associated with cutaneous ulceration. We present a case of a severe leg ulcer that likely occurred from hydroxyurea use in a patient with a MTHFR polymorphism.



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Agminated Pyogenic Granuloma–Like Growth Arising in a Congenital Hemangioma

from ArchDerm - 01 Jul 14

Pyogenic granulomas (PGs), usually solitary and isolated, have rarely been reported to arise as lesions within preexisting vascular malformations. Multiple, distinct, PG-like lesions within capillary or arteriovenous malformations (AVMs) have been described. To our knowledge, no cases of solitary or agminated PG-type growths have been reported in congenital hemangiomas (CHs).



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Diffuse Cutaneous Pseudolymphoma Due to Therapy With Medicinal Leeches

from ArchDerm - 01 Jul 14

Primary cutaneous B-cell lymphoma and B-cell pseudolymphoma may show similar clinical and microscopic presentations and sometimes represent a real diagnostic challenge for both clinician and pathologist.



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Fingertip Purpura in a Dental Student An Unusual Manifestation of Methyl Methacrylate Dermatitis

from ArchDerm - 01 Jul 14

Methyl methacrylate (MMA) is a well-known sensitizer commonly found in dental resins, bonding agents, prosthetics, artificial nail adhesive, and industrial glues. Allergic contact dermatitis due to MMA is often seen in individuals with occupational exposure, such as those in the dental profession.




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Cutaneous Rosai-Dorfman Disease Successfully Treated With Low-Dose Methotrexate

from ArchDerm - 01 Jul 14

In 1969, Rosai and Dorfman first described a series of patients with sinus histiocytosis with massive lymphadenopathy, characterized by histiocytic infiltration of lymph nodes and tissue. To our knowledge, as of 2006, there were a total of 86 reported cases of cutaneous Rosai-Dorfman disease (CRDD) in the literature, with several additional cases reported since then.



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Paraproteinemia-Associated Scleredema Treated Successfully With Intravenous Immunoglobulin

from ArchDerm - 01 Jul 14

Scleredema is a fibromucinous connective tissue disease characterized by symmetric, nonpitting edema and induration of the face, neck, and trunk. Although the pathogenesis remains elusive, associations with infection, diabetes mellitus, and paraproteinemia have been established. Paraproteinemia-associated scleredema is typically characterized by a progressive course, for which no standard therapeutic protocol exists. To our knowledge, the patient described herein represents the first reported ca



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Syphilitic Aortitis in Secondary Syphilis

from ArchDerm - 01 Jul 14

Syphilis is a mainly sexually transmitted infection that may show a variety of symptoms at various stages. Syphilitic aortitis is a known complication of tertiary syphilis and can cause aneurysm of the aorta. In the era of antibiotics, cardiovascular syphilis has become very rare. Nevertheless it can cause life-threatening or even fatal symptoms and should therefore be diagnosed at an early stage.



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Hydraulic Expulsion of Tumbu Fly Larvae

from ArchDerm - 01 Jul 14

Furuncular myiasis is rarely observed outside of endemic areas, which may hamper accurate diagnosis. Herein we report 2 cases of Cordylobia anthropophaga larval removal using a hydraulic expulsion technique.



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Dr G. H. Armauer Hansen

from ArchDerm - 01 Jul 14

The Journal of Cutaneous DiseasesJuly 1914IN MEMORIAM.Dr. G. H. Armauerhansen.The members of the American Dermatological Association wish to place on record their appreciation of the great work of our late Honorary Fellow, Dr. Hansen; and our sorrow because he no longer lives to carry it on.Though most of us have never met him face to face, his name is familiar to us. To him the whole world is debtor because in 1874 he demonstrated that leprosy is due to a bacillus, that it is therefore communic



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Tungiasis “The Greatest Curse That Has Ever Afflicted Africa”

from ArchDerm - 01 Jul 14

Because of air travel, diseases formerly restricted to tropical and subtropical areas may also now be observed in countries with temperate climates. Among these diseases, one often underrecognized by Western dermatologists is tungiasis, an infestation caused by penetration in the skin of the gravid female of the flea Tunga penetrans. This infestation occurs in poor communities in South America and Africa and sporadically affects travelers to endemic areas. Medical entomology claims that the Sout


 

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