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This Month in Archives of Dermatology
Sep 2012

This Month in Archives of Dermatology

Arch Dermatol. 2012;148(9):986. doi:10.1001/archdermatol.2011.549

Psoriasis is a common, chronic inflammatory disease associated with increased risk for myocardial infarction, stroke, metabolic syndrome, and cardiovascular mortality. In this population-based cohort study, Azfar et al demonstrate that psoriasis is an independent risk factor for the development of type 2 diabetes mellitus (DM) in a severity-dependent manner, with severe psoriasis conferring a higher risk than mild psoriasis. These data suggest that patients with psoriasis should be encouraged to undergo therapeutic lifestyle changes and appropriate screenings to lower their risk of DM.

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Viral warts are common in childhood and can spread rapidly by cutaneous contact or autoinoculation. Cryotherapy is the most widely used treatment, but young children may poorly tolerate it. Nonpharmacologic approaches to reducing anxiety levels are preferred for this minor procedure. In this nonblinded before-after trial, Tey et al demonstrate that preprocedural anxiety levels in preschool children were significantly reduced with the use of a portable video player showing Barney or Kung Fu Panda. The portable video player was a safe, easy to use, and a cost-effective distraction for the children.

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Commercial tanning beds for cosmetic use were introduced in the 1970s, and their use has soared. Long-term health risks of indoor tanning include premature aging, immune suppression, cataracts, and skin cancers. In 2003, the International Commission on Non-Ionizing Radiation Protection provided recommendations against the use of UV-emitting appliances for nonmedical purposes and classified youths 18 years or younger as a high-risk group. In this cross-sectional study, Pawlak et al demonstrate that the number of countries with nationwide indoor tanning legislation restricting youth access has increased from 2 countries in 2003 to 11 in 2011.

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Melanoma is the deadliest form of skin cancer, and despite significant recent advances in systemic therapies, the prognosis for advanced disease remains poor. The greatest potential to lessen the burden of melanoma is through detection during the early stages of tumorigenesis. Previous studies have shown that current medical school curricula do not provide adequate training to facilitate detection of skin cancer. In this cohort study, Liebman et al demonstrate that students receiving a dermoscopy tutorial in addition to skin cancer examination teaching improved in their diagnosis of cutaneous lesions. Incorporating dermoscopy training in medical school curricula may be an effective means of enhancing skin cancer knowledge.

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Transverse nasal crease is an uncommonly reported entity that likely represents an embryonic fault line. Transverse nasal milia have also been reported in the same location, suggesting that they are variants of the same entity, and Waller and Haber describe 2 such cases in this series. Located at the border of the middle and lower third of the nose, a transverse nasal crease can present with a wide clinical spectrum ranging from a faint erythematous line to a hypopigmented groove with a depth and width of several millimeters. These may be distinguished from the allergic nasal crease, a similar line seen in atopic patients as a result of persistent and repetitive manipulation of the nasal tip upwards.

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