A refractory case of erythromelalgia involving the ears

Erythromelalgia is a rare syndrome that is characterized by episodic attacks of burning pain, erythema, and increased temperature usually affecting the extremities, which is aggravated by warmth or exercise. We describe a patient with a 3-year history of refractory burning pain and red ears. A review of clinical features, disease classification, associated diseases, and treatment of this disease is presented.     

Self,friends, and lovers: structural relations among Beck Depression Inventory scores and perceived mate values

BACKGROUND: We used an economic model based on evolutionary theory to guide an examination of relations among self-reported depressive symptoms and ratings of mate values of self, social, and sexual partners. This model treats assortative mating as a form of social exchange between partners of socially and sexually desirable traits. METHODS: Two studies used variants of the Mate Value Inventory (MVI), a multivariate assessment of attributes desired in social or sexual partners. For study 1, 115 male and 124 female undergraduates provided self reports on four forms of the MVI-11 and on the Beck Depression Inventory (BDI); for study 2, 208 male and 277 female undergraduates provided self reports on seven forms of the MVI-7 and on the BDI-II. RESULTS: Both multisample structural equations models indicated that the parameters were statistically equivalent between female and male subsamples and provided an adequate fit to the data. The models revealed significant relations between the mate values ascribed to the self and those ascribed to short- and long-term partners as well as best friends. Furthermore, greater BDI scores significantly predicted lesser ratings of mate value for the self, and hence indirectly predicted lesser ratings of mate value for all types of partners evaluated. LIMITATIONS: Although the data obtained from the MVI demonstrated good psychometric validity, external validity has not yet been established. CONCLUSIONS: The results are consistent with models predicting: (1) assortative mating by mate value, (2) differential exchange rates of mate value for different types of partners, (3) a negative relation between depressive symptoms and assessment of one's own mate value, and (4) a possibly consequential mismatch of mate values when one partner exhibits or recovers from significant depressive symptoms. The results are inconsistent with models predicting (5) a generalized negativity bias due to depression.     

Interpretation of cutaneous biopsy specimens: choice of pathologist by primary care practitioners

BACKGROUND: Primary care providers (PCPs) have limited training in recognizing common skin disorders, and additional emphasis may be placed on laboratory evaluation, including skin biopsies. METHODS: Primary care providers in Miami, Fla, were surveyed regarding skin biopsy and excision practices and histologic interpretation. They then participated in an examination, using 20 high-quality color photographs of common dermatologic disorders. RESULTS: Of the 80 PCPs who participated, 42% currently do skin biopsies and consult general pathologists for interpretation. Another 20% of PCPs intend to do biopsies within the next 5 years. Only 33% prefer to have a dermatopathologist interpret histopathology. We found no correlation between PCPs' scores on diagnostic testing and whether they do skin biopsies. CONCLUSION: Nearly all PCPs doing skin biopsies in our study sample use general pathologists to interpret histopathology. The limited training in clinical dermatology of both PCPs and general pathologists may result in compromised clinical-pathologic correlation.     

An update on hypercoagulable disorders

Venous thrombosis is a cause of considerable morbidity and is often responsible for chronic venous disorders that frequently lead to visits to dermatologists and others involved in wound healing. Over the past several years, many new causes of thrombophilia have been identified and have dramatically altered the approach to patients presenting with thrombosis. Newly described abnormalities associated with thrombophilia include the syndrome of activated protein C resistance, the prothrombin 20210A mutation, hyperhomocysteinemia, and elevated levels of coagulation factors VIII and XI. Clinicians can now frequently determine causes of thromboses that have previously been deemed idiopathic.