Primary cutaneous Ewing sarcoma - Case report

Ewing sarcoma is a primitive neuroectodermal tumor rarely occurs in the skin andsobcutaneous tissues. Generally Ewing''s sarcoma is a primary bone tumor, butwhen present in soft tissues it characterizes an extremely uncommon clinicalpicture. It usually involves the deep subcutaneous tissue or muscles, and morerarely occurs like a primary skin cancer. Most patients are white, women, and inthe second decade of life. The clinical features are a superficial mass, inaverage measuring 2-3 cm, of soft consistency, freely mobile and sometimespainful. The more affected locations are upper and lower extremities, trunk,head, neck or multiple lesions. The presence of metastases is very rare.     

Sample size: how many participants do I need in my research?

The importance of estimating sample sizes is rarely understood by researchers,when planning a study. This paper aims to highlight the centrality of samplesize estimations in health research. Examples that help in understanding thebasic concepts involved in their calculation are presented. The scenarioscovered are based more on the epidemiological reasoning and less on mathematicalformulae. Proper calculation of the number of participants in a study diminishesthe likelihood of errors, which are often associated with adverse consequencesin terms of economic, ethical and health aspects.     

The impact of rosacea on quality of life: effects of demographic and clinical characteristics and various treatment modalities

Summary Background Rosacea has a major psychosocial impact on a patient’s life. Objectives To determine the impact of rosacea on patient quality of life, the relationship of quality of life scores to clinical and demographic variables, and the change in quality of life following various treatments. Methods Patients’ demographic and clinical characteristics were recorded at their initial examination and their response to treatment and side‐effects were recorded additionally at their follow‐up examination. Rosacea severity was scored for each of four signs from 0 to 3. Patients were requested to complete Dermatology Life Quality Index (DLQI) questionnaires. Results A total of 308 patients took part in this study. Mean ± SD DLQI total score at the initial visit was 6·93 ± 5·18 and was related to patients’ age, sex, age at disease onset, subjective symptoms, triggering factors, previous treatments, rosacea severity scores and patients’ self‐assessment of ease of living with rosacea. Of these 308 patients, 164 completed the DLQI following treatment. Mean ± SD post‐treatment DLQI score was 4·36 ± 4·82. Post‐treatment scores were also related to sex, type of treatment modality, development of side‐effects, improvement of rosacea, rosacea severity scores and patients’ self‐reported ease of living with rosacea. Topical metronidazole, oral tetracycline and oral isotretinoin were observed to reduce signs and symptoms of rosacea and DLQI scores significantly at this repeat examination. Conclusions Rosacea affects patients’ lives to a moderate extent, and this can be assessed by using DLQI. DLQI is also sensitive to quality of life changes brought about by treatment of rosacea. As a preliminary result we can say that topical metronidazole, oral tetracycline and oral isotretinoin seem to improve quality of life of patients by improving lesions of rosacea more efficiently than other therapeutic agents.     

Quality of life in patients with lepromatous leprosy in China

Background Leprosy has an impact on patients’ quality of life (QoL). However, there has been no study specifically on the impact of the severest type of leprosy‐lepromatous leprosy on QoL. Objective To describe the use of Dermatology Life Quality Index (DLQI) among patients with lepromatous leprosy in China. Methods Sixty‐four inpatients with lepromatous leprosy of Shangluo hospital and Hanzhong hospital and sixty‐four controls (healthy volunteers or patients with other dermatoses) matched for age and gender were asked to complete DLQI questionnaires from 2 September 2008 to 20 December 2008. Extensive data were collected besides DLQI, including demographic data and disease‐related characteristics. Absence or presence of disability among patients with lepromatous leprosy was evaluated at the same time. Results The overall mean DLQI score for lepromatous leprosy (18.78) was higher than that for control (9.00) (P < 0.001). Patients with lepromatous leprosy scored significantly higher for all items (P < 0.001) except Q4 (clothes choice). Controls scored significantly lower for all domains of DLQI. Scores of LL increased markedly with increasing clinical severity, but were not associated with educational level, gender, age and disease duration. The inter‐item correlation averaged 0.240 and Cronbach’s alpha was 0.759, indicating high internal consistency. Conclusions This is the first exclusive study to attempt to measure the impact of lepromatous leprosy on QoL. Lepromatous leprosy has a severe impact on QoL.     

Local injection of botulinum toxin A: An alternative therapy for axillary osmidrosis

The objective of this study was to investigate the efficacy of local injection of botulinum toxin A for treating axillary osmidrosis. One hundred and fifty patients with axillary osmidrosis were randomly divided to receive botulinum toxin A injection treatment (50 U of botulinum toxin A was injected intracutaneously into 6–20 different sites within each axilla, n = 74) or surgical excision of the apocrine glands (n = 76). The patients were followed up for 1–3 months to analyze the therapeutic effect and complications of the two methods. The curative effect in patients with mild and moderate axillary osmidrosis was not significantly different between the botulinum toxin A injection group and operation group. However, for patients with severe axillary osmidrosis, surgery treatment seemed to be superior to botulinum toxin A treatment (P = 0.005). There was also no significant difference in the modified Dermatology Life Quality Index between the two treatments. Two cases showed complications related to hemorrhage and incision infection in the operation group. In conclusion, local injection of botulinum toxin A is a safe, fast and effective treatment for mild and moderate axillary osmidrosis, but the long‐term effect remains to be further investigated.