The cause of pityriasis rosea (PR) remains unknown. Conflicting evidence exists for the association of PR with human herpesvirus 7 infection. Adopting a regression model, Chuh et al identified 3 statistically significant temporal clusters in a series of 41 patients with PR. This significant temporal clustering was found to be independent of seasonal variation, offering additional support to the concept that PR is caused by an infectious agent.
The combination of clinically administered phototherapy with retinoids is more effective than either modality alone for the treatment of psoriasis. In this prospective open trial, the combination of acitretin with commercial tanning bed use at carefully selected salons was also found to be effective. Carlin et al cautiously suggest a potential role of this psoriasis therapy in settings where psoralen–UV-A or UV-B is inaccessible.
The term epidermolysis bullosa simplex (EBS) describes a heterogeneous group of heritable mechanobullous diseases. The molecular basis of most cases of EBS involves mutations in 2 genes encoding keratin 5 or 14. In this case series from Israel, Ciubotaru et al identified several novel mutations in these genes and noted a relatively high incidence of autosomal recessively inherited cases.
Bone marrow contains mesenchymal stem cells, multipotent stem cells, and inflammatory cell progenitors that offer promise for the treatment of nonhealing chronic wounds. In this case series, Badiavas and Falanga treated patients with chronic wounds resistant to conventional and advanced modalities with topical autologous bone marrow cells. Wound healing was noted in each case, and posttreatment biopsy specimens suggested engraftment of the applied cells accompanied by dermal rebuilding.
A, Increased vascularity and evidence of good granulation tissue 5 weeks after application of bone marrow aspirate. B, Healed wound following administration of bone marrow aspirate and cultured bone marrow cells.
Indoor tanning by teenagers is a widespread and increasingly popular practice. Dellavalle et al assessed youth access laws for indoor tanning in English-speaking industrialized nations and compared these with youth access restrictions for tobacco. Unlike tobacco regulation, indoor tanning regulations were found to be relatively few, despite widely accepted evidence that youth is the most critical period for increasing lifetime skin cancer risk through UV exposure.
Leishmania major is the most common cause of Old World leishmaniasis. Many therapeutic options for cutaneous leishmaniasis are available, including pentavalent antimonials, amphotericin B, oral ketoconazole, topical paromomycin, and locally destructive therapies. None of these modalities is ideal. Enk et al offer the first clinical demonstration of the efficacy of photodynamic therapy with δ-aminolevulinic acid in this cutaneous parasitic infection.
This Month in Archives of Dermatology. Arch Dermatol. 2003;139(4):423. doi:10.1001/archderm.139.4.423