Fifteen percent of patients with diabetes experience an ulcer at some time during their life, putting them at risk for infection, osteomyelitis, gangrene, and limb amputation. Topical tretinoin has been shown to improve the healing of partial and full-thickness wounds when used prior to wounding, but the benefit on open wounds has been less clear. In this randomized, double-blind, placebo-controlled trial involving 24 patients with foot ulcers without evidence of peripheral vascular disease, Tom et al demonstrate the benefits of short-contact topical tretinoin when combined with standard therapy.
Improved healing and formation of granulation tissue in a representative patient treated with topical 0.05% tretinoin solution.
There are many sources of subcutaneous emphysema. Cervicofacial emphysema in particular may result from invasion of compressed air into soft tissue during dental procedures such as tooth extraction, restorative dentistry, dental implant surgery, root canal, or periodontal treatment. In this report, Frühauf et al describe 2 patients with subcutaneous emphysema following dental treatment, emphasizing that the clinical findings of sudden onset of swelling with crepitation in the absence of erythema, tenderness, or lymphadenopathy are often recognizable in the dermatologic clinical setting.
Antibodies directed against Kaposi’s sarcoma–associated herpesvirus (KSHV), or human herpesvirus 8, are almost always detectable in cases of classic Kaposi’s sarcoma (CKS), which primarily affects elderly Mediterranean and Eastern European men. To assess the intrafamilial patterns of KSHV transmission, Guttman-Yassky et al tested serum samples from patients with KSHV and their first-degree relatives, identifying a relatively high seroprevalence of antibodies to KSHV among family members of patients with CKS. Exposure to saliva of infected individuals in the familial setting may be a major mode of transmission.
Automated diagnostic instruments may be able to improve the rate of early diagnosis and treatment of melanoma that is essential to minimize the mortality rate. Menzies et al describe the diagnostic performance of one such instrument, SolarScan (Polartechnics Ltd, Sydney, Australia), using images from a set of 2430 lesions collected from 9 centers. Although absolute computer diagnosis may never replace clinical diagnosis, SolarScan was found to be a robust diagnostic instrument that may prove useful as an auxiliary for clinical decision making.
In the last few decades, dermoscopy has been used more often as a noninvasive diagnostic technique for diagnosing pigmented skin lesions. In this series of 83 cases, Ferrara et al compared the clinical, dermoscopic, and histopathologic features of Spitz nevi and present a clinicopathologic classification scheme based on these findings. Although overlapping features were observed among the different subtypes of Spitz nevi, asymmetry, both clinical and dermoscopic, was demonstrated to be the most useful indicator of histopathologic atypia.
This Month in Archives of Dermatology. Arch Dermatol. 2005;141(11):1351. doi:10.1001/archderm.141.11.1351