Articles & Issues

Mutations in the sonic hedgehog signaling pathway play a key role in the development of basal cell carcinomas. Specifically, mutations in the PTCH1 (also known as PTCH or PTC1) and SMO genes cause tum...

Background: Mohs micrographic surgery (MMS) has a low rate of surgical site infection (SSI) without the use of prophylactic antibiotics. In the studies to date, there has been variation in the steps t...

Trips abroad to underdeveloped countries for the purpose of providing dermatologic care (medical missions), while both exciting and gratifying, require planning and forethought. What do I bring? What ...

In the first part of the review, topical agents and first-line systemic treatment options for cutaneous lupus erythematosus were discussed whereas in the second part, recent information on efficacy, d...

Dermatitis herpetiformis (DH) is an immune-mediated cutaneous disease occasionally associated with celiac disease, but rarely associated with systemic lupus erythematosus (SLE). The combination of DH ...

In patients with cutaneous lupus erythematosus (CLE), it is important to provide instructions concerning methods of protection from sunlight and artificial sources of ultraviolet radiation. Topical co...

Background: Few studies have extensively examined the prevalence of hair care practices and their association with scalp and hair conditions in African American girls. Objectives: We sought to determi...

Background: Nevus simplex (NS) is a common birthmark on the forehead, glabella, upper eyelids, and nape. More widespread involvement can be confused with port-wine stains (nevus flammeus) and other va...

Background: For decades silver-containing antibiotics such as silver sulfadiazine (SSD) have been applied as standard topical therapy for patients with partial-thickness burns and venous stasis ulcers...

Background: Onychoheterotopia is an extremely rare condition in which the nail tissue grows outside the classic nail unit of the dorsal fingers and toes. It presents as either small outgrowths of a de...

Longitudinal erythronychia is a frequent nail presentation with a limited differential diagnosis. This clinical entity may be divided into cases that involve one (localized) or multiple (polydactylous...

Background: Proteus syndrome is a rare overgrowth disorder that almost always affects the skin. Objective: Our purpose was to evaluate progression of skin lesions in patients with Proteus syndrome. Me...

The Patient Protection and Affordable Care Act will have substantial effects on the US health care system. Physicians hold varied opinions regarding the overall merits or drawbacks of the health syste...

Background: The role of a hypercoagulable state in the pathogenesis of calciphylaxis has yet to be determined. Objective: We sought to find evidence of an association between hypercoagulability and ca...

In its annual sunscreen report, the Environmental Working Group claimed that 41% of the sunscreens on the market contain retinyl palmitate (RP), an ester form of vitamin A. Based on its internal analy...

Background: Intravenous immunoglobulin (IVIg)–a relatively new approach to treat pemphigus–lowers serum levels of pemphigus antibodies; however, the optimal way to use this agent is unknown. Objective...

Background: Prevention strategies in atopic dermatitis (AD) using allergen avoidance have not been consistently effective. New research reveals the importance of the skin barrier in the development of...

An association between obesity and psoriasis has been reported. For a variety of reasons, obese persons with psoriasis are often more difficult to treat. We sought to review the literature on obesity ...

Infectious agents have long been suspected as potential causative agents in cutaneous T-cell lymphoma (CTCL). Tissues of patients with CTCL have been evaluated for evidence of infection with a number ...

Upon the passing of J. Graham (Skee) Smith, Jr, MD, on May 18, 2010, modern dermatology lost a giant. As former trainees, we lost a durable and generous mentor. In many ways, it is easy to summarize t...

Infective dermatitis (ID) is a chronic, relapsing dermatitis associated with human T-lymphotrophic virus (HTLV)-1 which was initially described in Jamaican children. Although most cases have been repo...

Background: Onychomatricoma (OM) is a rare benign tumor of the nail matrix in which genome-wide analyses have never been performed. It is clinically characterized by an increased transversal curvature...

Background: Cutaneous polyarteritis nodosa (CPN) is an uncommon disorder that can be difficult to manage effectively. We have previously suggested that CPN might be associated with the presence of ant...

Background: In 1925, Dr Marie Unna described a rare form of hereditary hypotrichosis in a German multigenerational family. This was later termed “Marie Unna hereditary hypotrichosis” (MUHH). MUHH is a...

Recent studies have found that psoriasis is linked to a higher rate of obesity, and that obesity itself is a risk factor for the development of psoriasis. There are two recent reports of chronic sever...

Extramammary Paget disease is a rare condition that most commonly affects the anogenital region in the elderly. The treatment of choice has been surgical excision of the affected area with adequate de...

Palmar fasciitis and polyarthritis syndrome is a rare, disabling, paraneoplastic condition of unknown pathogenesis. There is no known effective treatment, although the condition may be halted by contr...

Background: The incidence of pneumocystis pneumonia (PCP), an opportunistic infection caused by Pneumocystis jiroveci, in patients taking immunosuppressive medications for dermatologic indications is ...

Background: Patch testing to a standard screening series of allergens in combination with supplemental cosmetic allergens is often used to diagnose allergic contact dermatitis due to personal care pro...

Background: Inherited ichthyoses belong to a large, clinically and etiologically heterogeneous group of mendelian disorders of cornification, typically involving the entire integument. Over the recent...

Generalized pustular and/or erythrodermic psoriasis may have severe or even lethal complications. A peculiar noninfectious acute respiratory distress syndrome (so-called "sterile pneumonitis") has bee...

Background: Pemphigus vulgaris (PV) is a blistering autoimmune bullous disease that is usually fatal without proper treatment. There are no clear treatment guidelines for PV at this time. Purpose: We ...

Background: Postadolescent acne is usually described as an inflammatory, mild-to-moderate dermatosis, frequently involving the lower third of the face, the jawline, and the neck. However, we have also...

Background: Psoriasis adversely affects health-related quality of life (HRQoL) in adults; however, little information exists about its impact on children and adolescents. Objective: The effect of etan...

In the digital age, personal identification by fingerprints (epidermal ridges) has become more frequent and is often required for biometric passports. The more fingerprints are analyzed, the more vari...

Background: Patients with psoriasis tend to be overweight, and the efficacy of fixed-dose biologics may be compromised by high body weight. Objective: We sought to determine whether the optimal dose o...

Background: Pruritus is a common symptom of psoriasis. In many clinical trials of psoriasis treatments, severity of pruritus is a patient-reported outcome. Objective: We sought to evaluate a patient-r...

Background: Calcipotriene has limited efficacy in treating psoriasis. By inhibiting proinflammatory cytokines such as interleukin-12, interleukin-23, and tumor necrosis factor-alfa, nicotinamide may e...

Background: National Resident Matching Program (NRMP) policy outlines the conduct expected by both program directors and residency applicants. However, recent studies and personal experiences have int...

We present two unique cases of fibrous hamartoma of infancy defined by giant-sized and/or multicentric cutaneous and subcuticular lesions—features not, to our knowledge, reported to coexist. We review...

Tyrosine kinases (TKs) are enzymes that catalyze the phosphorylation of tyrosine residues on protein substrates. They are key components of signaling pathways that drive an array of cellular responses...

Digital squamous cell carcinoma (SCC) presents a diagnostic challenge because of its relatively rare occurrence and mimicry of benign conditions. Although low-risk human papillomavirus (HPV) subtypes ...

Delayed wound healing is one of the major therapeutic and economic issues in medicine today. Cutaneous wound healing is an extremely well-regulated and complex process basically divided into 3 phases:...

Background: The management of Merkel cell carcinoma (MCC) has been complicated by a lack of detailed prognostic data and by the presence of conflicting staging systems. Objective: We sought to determi...

To the Editor: Angiotensin-converting enzyme (ACE) inhibitor–induced angioedema (AE) occurs with a reported incidence of 0.1% to 0.2% and may be life threatening in up to 20% of patients. Its pathomec...

Background: No systemic therapies are approved by the US Food and Drug Administration for the treatment of psoriasis in children and adolescents. Objective: We sought to evaluate the long-term safety ...

Intralesional chemotherapy for nonmelanoma skin cancer has existed for more than 5 decades. However, it is used so infrequently that recent consensus guidelines for the treatment of basal cell and squ...

Short anagen syndrome is an uncommon condition characterized by the inability to grow long hair and an increase in the number of hairs in telogen. The incidence of short anagen syndrome is poorly docu...

A patient with Hansen's disease received corticosteroids for a type 1 leprosy reaction and subsequently developed a new cutaneous lesion at the original biopsy site from which Mycobacterium fortuitum ...

Many physicians in the United States and other nonendemic countries lack familiarity with New World cutaneous leishmaniasis (CL) and fail to include it in their differential diagnosis when seeing pati...

The conventional treatment for the autoimmune bullous skin diseases is broad-spectrum immunosuppressive regimen typically combining systemic corticosteroids with adjuvant immunosuppressive therapeutic...

Stem cell–based therapies are expected to have a great impact on the medicine of the 21st century. The focus of dermatologic stem cell research is on the epidermis and the hair follicle. In contrast, ...

Previous systematic reviews of silver-impregnated dressings have been contradictory regarding the healing of leg wounds/ulcers. Our systematic review was restricted to randomized controlled trials. Co...

During the past two decades, systemic μ-opioid receptor antagonists (MORA) have been used in the treatment of various forms of chronic pruritus. In a number of case reports, case series, and controlle...

Cutaneous collagenous vasculopathy is characterized by generalized cutaneous telangiectasia and unique microscopic and ultrastructural vascular changes, consisting of marked collagen deposition within...

Disseminated superficial actinic porokeratosis (DSAP) is the most common form of porokeratosis, occurring mainly in women on the extremities as atrophic patches rimmed by a ridge of keratin (the corno...

Background: The Melasma Area and Severity Index (MASI), the most commonly used outcome measure for melasma, has not been validated. Objective: We sought to determine the reliability and validity of th...

Intralesional agents have a role in the management of cutaneous malignancies. In this article, the efficacy, side effects, strengths, limitations, costs, and practical considerations regarding the use...

Background: Several previous studies have reported inverse associations between cigarette smoking and melanoma. Often these studies have not adjusted for ultraviolet (UV) exposure history, skin type, ...

Cutaneous metastases occur in 0.7% to 9% of all malignancies. In women, cutaneous metastases occur most often in breast cancer, followed in order by colorectal carcinoma, melanoma and ovarian carcinom...