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This Month in Archives of Dermatology
May 2002

This Month in Archives of Dermatology

Arch Dermatol. 2002;138(5):579. doi:10.1001/archderm.138.5.579
Mad Cows, Prions, and Wrinkles

Considerable public concern exists regarding the safety of bovine-derived products, especially after the mid-1980s epidemic of bovine spongiform encephalopathy in England. Potential human exposure to transmissible spongiform encephalopathies exists in some cosmetic injectables. However, this review reassures dermatologists and patients of the extremely high safety profile of the currently available injectables.

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In the United States, Blacks and Asian/Pacific Islanders Are More Likely Than Whites to Seek Medical Care for Atopic Dermatitis

Population-based studies suggest an increase in prevalence of atopic dermatitis in black and/or Asian children. National Ambulatory Medical Care Survey data reveal that these groups are much more likely to visit physicians for atopic dermatitis than are whites. The genetic, cultural, and environmental factors that may contribute to this increased incidence and prevalence are discussed, as are strategies for early intervention based on these factors in these potential target populations.

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Successful Treatment of Cutaneous Sarcoidosis Using Topical Photodynamic Therapy

Sarcoidosis is a multisystem disease with well-recognized clinical and radiologic features, characterized pathologically by the formation of noncaseating granulomas in many organs, including the skin. No consistently effective therapy for sarcoidosis exists. Karrer et al describe a novel therapeutic approach to sarcoidosis using topical photodynamic therapy with 5-aminolevulinic acid, which achieves dramatic results for a patient with previously recalcitrant cutaneous lesions of sarcoidosis.

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Raynaud Phenomenon and Behçet Disease: Diagnosis With Technetium Tc 99m Methylene Diphosphonate Bone Scan and Treatment With Continuous Sympathetic Block

Önder et al describe the unusual association of Behçet disease and Raynaud phenomenon coexisting in the same patient. Three-phase bone scintigraphy was performed, during which early blood pool phase images revealed decreased tracer uptake in this patient's second, third, and fourth fingers. This hypoperfusion improved significantly following continuous sympathetic block.

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Psoriasis as a Model for T-Cell–Mediated Disease: Immunobiologic and Clinical Effects of Treatment With Multiple Doses of Efalizumab, an Anti–CD11a Antibody

Leukocyte function–associated antigen 1 (LFA-1) plays an important role in T-cell activation through its interaction with intercellular adhesion molecule 1. This interaction presents an attractive therapeutic possibility for T-cell–mediated diseases such as psoriasis. In this study, Gottlieb et al used a monoclonal antibody directed toward the CD11a subunit of LFA-1. Intravenous administration of this monoclonal antibody to patients with moderate to severe psoriasis resulted in substantial disease improvement.

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Reliability of the Histopathologic Diagnosis of Malignant Melanoma in Childhood

Malignant melanoma (MM) is rarely diagnosed in childhood, and when it is, unusual clinical and histologic features often complicate the diagnosis. The distinction between MM and Spitz nevi or pigmented spindle cell nevi remains one of the most difficult problems facing dermatopathologists. Wechsler et al recruited 8 dermatopathologists to review slides, and the interrater reliability in the diagnosis of MM in children was assessed. The concordance of diagnoses among pairs of experts was generally only poor to moderate, suggesting that the reliability of the pathologic diagnosis of MM in childhood is poor, even in the hands of experts.

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