Does treatment with propranolol affect quality of life in infantile hemangioma patients and their parents?

This study compares the quality of life (QoL) of infantile hemangioma (IH) patients and their parents at the beginning of the involution phase with QoL in the growth phase. Additionally, the differences in QoL between propranolol‐treated patients and non‐treated patients are assessed. Overall, QoL seems to improve, even before involution occurs. Due to the efficacy of propranolol treatment, the impact on QoL remains relatively mild even in patients with severe IH.     

Tumor lysis syndrome after propranolol therapy in ulcerative infantile hemangioma: rare complication or incidental finding?

A 33-day-old female with an ulcerated infantile hemangioma (IH) undergoing oral therapy with propranolol 2 mg/kg per day developed hyperkalemia and hyperphosphatemia 24 h after starting medication. No electrocardiographic or clinical abnormalities secondary to the electrolyte changes were noticed. A laboratory tumor lysis syndrome (TLS) was diagnosed after excluding other causes of electrolyte imbalance in the diagnostic workup. No treatment was required to reverse the TLS condition, and the propranolol therapy was continued as the electrolyte alterations were only mild. One month later, the IH was remarkably reduced in size and no longer ulcerated. Maintenance of propranolol was extended for a total of 6 months. Parallel to the gradual involution of the IH, serum potassium and phosphorus levels returned within normal levels. We suggest that TLS may be a rare complication of ulcerated IH treated with propranolol. Clinicians must be aware and order appropriate screening tests for TLS in patients at risk.     

Three cases of oral mucosal tuberculosis in patients on tumour-necrosis-factor-α blockers

We present three cases of oral mucosal lesions caused by Mycobacterium tuberculosis in patients treated with anti-tumour necrosis factor-α for psoriasis or rheumatoid arthritis. Diagnosis of oral mucosal tuberculosis was not easily established in any of the cases. A comparison between these cases and other previously described forms of oral mucosal tuberculosis is presented.     

Are there racial and sex differences in the use of oral isotretinoin for acne management in the United States?

BACKGROUND: Treatment of various diseases has been noted to vary by patient demographics. There is reason to suspect that there may be sex and racial differences in the treatment of severe acne. OBJECTIVE: We sought to determine if treatment of severe acne with oral isotretinoin varied with patient sex, race, or both. METHODS: We analyzed the demographics of patients with acne and patients using oral isotretinoin, minocycline, and tetracycline recorded in the 1990 to 1997 National Ambulatory Medical Care Survey. RESULTS: There were 35 million visits to physicians for the treatment of acne between 1990 and 1997, and isotretinoin was prescribed at 5.8 million (17%) of these visits. Per capita visit rates for acne among whites was 2.3 times that of blacks, and whites were 1.8 times more likely to receive isotretinoin at acne visits. Per capita, women had 1.4 times as many visits for acne as men, but men were 1.7 times more likely than women to receive isotretinoin at an acne visit. Dermatologists managed 83% of all isotretinoin visits. Dermatologists accounted for 100% of isotretinoin visits for which pregnancy prevention education and counseling was reported. CONCLUSIONS: Patients who are black receive less oral isotretinoin than those who are white, and the expense of isotretinoin appears to be one factor in this difference. Women are less likely than men to receive isotretinoin at acne visits. Expense does not appear to be a factor in this difference. Dermatologists have more experience than nondermatologists managing acne, prescribing isotretinoin, and counseling women treated with isotretinoin concerning pregnancy prevention. Pregnancy prevention is an essential component of isotretinoin use in women that must not be ignored.     

Treatment of dermatosis papulosa nigra with a 1064 nm Nd:YAG laser: Report of two cases

Dermatosis papulosa nigra (DPN) is a chronic skin condition characterized by verrucous hyperpigmented papules on the face, neck and upper trunk in African American patients. The lesions are more common in females and in older patients. Although the lesions are benign, treatment is often sought for cosmetic reasons. We report two cases of patients with facial DPN who achieved an excellent cosmetic result following a single treatment with a long‐pulsed 1064?nm Nd:YAG laser. We suggest this modality for consideration in treating patients with DPN.     

The use of sucralfate suspension in the treatment of oral and genital ulceration of Beh?et disease: a randomized, placebo-controlled, double-blind study.

OBJECTIVE: To determine the efficacy of topically applied sucralfate suspension in the treatment of oral and genital ulceration of Beh?et disease. DESIGN AND SETTING: A randomized, placebo-controlled, double-blind study at a university referral center. PATIENTS: Forty patients with Behcet disease were included in the study. INTERVENTION: Patients were given topical sucralfate or placebo 4 times a day for 3 months and examined clinically at biweekly intervals. MAIN OUTCOMES MEASURES: For each lesion, the mean frequency, healing time, and pain were evaluated during the pretreatment, treatment, and follow-up periods. No patients were given any concurrent disease-specific or immunosuppressive topical and systemic drugs during the 9-month study period. RESULTS: Of the 40 patients included in the study, the results in 30 patients (16 patients treated with sucralfate and 14 patients treated with placebo, ranging in age from 16 to 52 years [mean+/-SD age, 34.3+/-8.1 years]) were evaluable for efficacy. Treatment with sucralfate decreased significantly the mean frequency, healing time, and pain of oral ulceration and healing time and pain of genital ulceration compared with the pretreatment period. The effectiveness of sucralfate on the frequency and healing time of oral ulceration continued during the post-treatment period. In the placebo group, no significant difference was found in measured parameters of oral and genital ulceration except the pain of the oral ulceration between the pretreatment and treatment periods. CONCLUSION: Our results showed that topical sucralfate suspension is an easy, safe, inexpensive, and effective treatment for oral and genital ulceration in patients with Beh?et disease.     

Sibling cases of Henoch-Schönlein purpura in two families and review of literature

Abstract:  The etiology and pathogenesis of Henoch–Schönlein purpura is unknown and few studies about familial cases of this disease have been reported. In this study, four Henoch–Schönlein purpura patients coming from two Chinese families were described. No genetic and environmental factors were found to be responsible for the occurrence of the four cases of HSP in tow families in this study.     

The clinical spectrum of dermatomyositis and the new autoantibodies – with regard to two clinical cases with distinct associations

Dermatomyositis is a rare idiopathic inflammatory myopathy associated with different autoantibodies (anti-MDA5, anti-TIF1-γ) which are linked with typical and distinct phenotypes of dermatomyositis. We describe two cases that illustrate these diverse cutaneous and systemic manifestations.     

The treatment of plantar warts using microwave—A review of 85 consecutive cases in the United States

Background

Plantar warts (verrucae plantaris) are a common source of pain for patients and are often refractory to treatment. Previous work has shown a high clearance rate of verrucae using a surface-based microwave device (Swift®).

Aims

To assess the efficacy, defined as the complete visible clearance of warts, in patients with verrucae plantaris receiving microwave treatment.

Patients

We undertook a retrospective review and identified records of 85 patients who underwent a course of microwave treatment at a single US-based podiatry centre. Efficacy was analyzed on the basis on intention-to-treat.

Results

In patients who received ≥1 session there was a complete clearance rate of 60.0% (51/85) (intention-to-treat; 59 patients completed treatment, 26 lost to follow-up) and 86.4% (51/59) per treatment completion; no significant differences in clearance rates of children and adults were observed (61.0% [25/41] vs. 59.1% [26/44]). There were 31 patients who received three sessions of microwave therapy with a clearance rate of 71.0% (22/31) as per intention-to-treat (27 patients completed treatment, 4 lost to follow-up). An average of 2.3 sessions (SD: 1.1; range: 1–6) was required for the complete clearance of plantar warts. Complete clearance was also observed in some patients with recalcitrant warts following additional treatment sessions (42.9% [3/7]). A significant reduction in wart related pain was reported for all patients undergoing treatment. Some patients continued to report a reduced amount of pain post-therapy compared with pretherapy.

Conclusions

Microwave treatment of verrucae plantaris appears to be a safe and effective procedure.     

Pentoxifylline--efficient in the treatment of venous ulcers in the absence of compression?

The aim of the study was to test the efficacy and tolerability of pentoxifylline on the healing of venous ulcers in the absence of standard limb compression. The study used a prospective randomized, open, controlled, comparative, parallel group design. The study included 80 eligible patients with confirmed venous ulcers (with clinical and photoplethysmography findings). The patients received either pentoxifylline 1200 mg per day (3 x 400 mg) orally in addition of local therapy, or the same local therapy alone. The main outcome measures were complete healing of ulcers, change in the ulcer area over the six-month observation period, and tolerability of the drug. The results showed that complete healing occurred in 23 (57.5%) patients receiving pentoxifylline and 11 (27.5%) patients without pentoxifylline (log rank test =2.49, p=0.013). Unwanted effects of pentoxifylline occurred in 11/40 (27.5%) patients but were mild. Pentoxifylline is concluded to be efficacious in healing of venous ulcers in patients unable to tolerate compression therapy.