The cyanoacrylate group of tissue adhesives has been studied for use in surgical procedures for more than 40 years. The tissue adhesive octyl cyanoacrylate is flexible and strong, and is currently being used in children in an emergency setting for laceration repairs. However, there have been no formal reports on the use of this material for the closure of excisional wounds in children. Bernard et al compare the cosmetic outcome and complication rates of cutaneous excisional biopsies closed with octyl cyanoacrylate vs those closed with conventional monofilament sutures. Complication rates were similar between groups, but the cosmetic outcome with standard suturing was superior to wounds closed with octyl cyanoacrylate, suggesting that tissue adhesives may not be as effective in achieving optimal cosmesis for excisional wounds or those under greater tension.
The characteristics and prevalence of adult acne have been defined, but the duration and course of treated acne in adult women has not been specifically described previously. Treatment failures are common in this population, and recurrences following isotretinoin therapy occur in 15% to 30% of adult female patients. Shaw and White surveyed women with acne to determine the degree of persistence, exacerbating factors, and treatment requirements, in an effort to better characterize the course of acne in adult women and to promote more effective therapy.
Hemangiomas are the most common tumors of infancy and childhood. When treatment is required because of interference with normal function or because of serious disfigurement, the mainstay of medical therapy remains systemic glucocorticoids. However, dosing recommendations, duration of therapy, recommendations for monitoring during and after therapy, and methods of tapering vary widely. Bennett et al use quantitative systematic review techniques in this meta-analysis to determine the efficacy of systemic corticosteroids in the treatment of enlarging, problematic, infantile cutaneous hemangiomas.
Intermittent sun exposure may be relatively more important than cumulative sun exposure in the pathogenesis of basal cell carcinoma (BCC). Timing of sun exposure may also be an important factor. Corona et al examine the potential risk factors for the development of BCC. The main risk factors identified included the number of weeks spent at the beach before the age of 20 years, the presence of actinic keratoses or solar lentigines, and a family history of skin cancer. Early life exposure to time spent at the beach was a stronger predictor of BCC than subsequent exposures, suggesting that childhood patterns of UV light exposure may be particularly relevant to the pathogenesis of BCC.
There are now several Food and Drug Administration–approved topical treatments available for herpes labialis. The relative efficacy of these products is obscured by the absence of any trial directly comparing them and the use of clinical study designs with differing methods. McKeough and Spruance describe the results of controlled trials of topical penciclovir, acyclovir, and n-docosonal for the treatment of primary herpes simplex virus type 1 infection in a guinea pig model. In this model, the relative efficacy of penciclovir cream was greater than acyclovir cream, acyclovir cream was greater than or equal to acyclovir ointment, and acyclovir ointment was greater than n-docosanol cream, a rank order that generally parallels results found in clinical trials.
This Month in Archives of Dermatology. Arch Dermatol. 2001;137(9):1145. doi:10.1001/archderm.137.9.1145