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This Month in Archives of Dermatology
February 2011

This Month in Archives of Dermatology

Author Affiliations
 

ROBIN L.TRAVERSMD

Arch Dermatol. 2011;147(2):157. doi:10.1001/archdermatol.2011.7
Impact of Melanoma on Patients' Lives Among 562 Survivors

Although the prognosis is relatively good for about 80% of patients with melanoma, they remain at risk for disease progression and have an increased risk of developing subsequent melanomas. In this cross-sectional survey, Holterhues et al used the 36-Item Short-Form Health Survey, Impact of Cancer (IOC) questionnaire, and specific melanoma-related questions to demonstrate that women were significantly more likely to report higher levels of both positive and negative IOC. The impact of melanoma appeared to be specific and more substantial in women, which suggests that women may need additional care to cope optimally with their melanoma.

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A Randomized Comparison of Methods of Selecting Narrowband UV-B Starting Dose to Treat Chronic Psoriasis

When topical therapies for psoriasis prove insufficient, narrowband (NB) UV-B is often the standard next-line therapy. The minimal erythemal dose (MED) frequently guides the NB UV-B starting dose, but it remains unclear if this method offers greater efficacy than skin phototype–based starting doses. In this randomized, double-blind, clinical trial, Dawe et al demonstrate that there were no significant differences in the number of treatments to clearance among patients randomly allocated to a fixed starting dose based on skin phototypes compared with 70% MED or 50% MED.

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A Unique Presentation of an Epstein-Barr Virus–Associated Natural Killer/T-Cell Lymphoproliferative Disorder in a White Male Adolescent

Extranasal natural killer (NK)/T-cell lymphoma (ENKTL) and aggressive NK-cell leukemia are strongly associated with Epstein-Barr virus (EBV) and most often occur in middle-aged individuals. In this case report, Summers et al describe a 15-year-old boy who developed painful subcutaneous nodules and plaques on his abdomen, thighs, and legs while undergoing treatment with infliximab. Atypical EBV+ lymphoid cells of NK-cell origin were found to be infiltrating the subcutaneous adipose tissue and were also noted in the bone marrow, liver, stomach, and colon. This is the first case of an EBV+ ENKTL developing in the setting of tumor necrosis factor inhibitor therapy.

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Two Cases of Multiple Spitz Nevi

Spitz nevi are benign melanocytic proliferations with distinct histologic features. They are typically solitary, but some patients develop multiple lesions. Although most Spitz nevi are karyotypically normal, some may have balanced gains with tetraploidy, and others may have an isolated gain in locus 11p. In this report, Boone et al describe 2 patients with multiple Spitz nevi. Fluorescence in situ hybridization revealed balanced tetraploidy in one case and normal diploid cells in the other. Neither case showed diagnostic changes of melanoma, demonstrating how molecular techniques may be used to confirm the diagnosis of Spitz nevus in challenging cases.

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Development of the CLASI as a Tool to Measure Disease Severity and Responsiveness to Therapy in Cutaneous Lupus Erythematosus

The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a clinical tool that quantifies disease activity and damage in cutaneous lupus erythematosus (LE). The activity score is based on the degree of erythema, scale, mucosal lesions, and nonscarring alopecia. In this cohort study of 75 patients with cutaneous or systemic LE, Klein et al demonstrate that this tool can be used to categorize patients into severity groups and identify clinically significant improvements in disease activity. This analysis provides a foundation for the practical use of the CLASI in clinical trials.

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