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This Month in Archives of Dermatology
February 2004

This Month in Archives of Dermatology

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Copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2004

Arch Dermatol. 2004;140(2):155. doi:10.1001/archderm.140.2.155
Association Between Anticonvulsant Hypersensitivity Syndrome and Human Herpesvirus 6 Reactivation and Hypogammaglobulinemia

Anticonvulsant hypersensitivity syndrome (AHS) is a life-threatening, multiorgan system reaction characterized by rash, fever, tender lymphadenopathy, hepatitis, and leukocytosis with eosinophilia. The role of human herpesvirus 6 (HHV-6) reactivation as a possible etiologic factor in AHS has been recently suggested. In this case series, Kano et al report a transient decrease in the serum concentration of immunoglobulins and circulating B-cell counts in 10 patients with AHS and suggest that this hypogammaglobulinemia may set the stage for HHV-6 reactivation and the subsequent onset of AHS.

UV Radiation Exposure Related to Age, Sex, Occupation, and Sun Behavior Based on Time-Stamped Personal Dosimeter Readings

Solar UV radiation (UVR) is a well-known risk factor for cutaneous malignancies. To date, most personal UVR dosimetry studies have used dosimeters that yield limited cumulative UVR data and provide only a rough picture of personal exposure patterns. In this open prospective observational study, Thieden et al provide a finer view of personal solar UVR exposure by using a time-stamped personal dosimeter with time-stamped measurements logged every 10 minutes. These data suggest that a few simple interventions, such as lunching indoors at midday for beachgoers, may dramatically reduce UVR exposure.

Gender and Parenting Significantly Affect Work Hours of Recent Dermatology Program Graduates

In the past few decades, there has been a dramatic gender shift in medicine. Where women were once a small minority of medical school classes, they now make up nearly 50% of entering medical students. Women currently make up the majority of dermatology residency classes. Some studies suggest that female physicians often choose to work fewer hours weekly than their male colleagues, and in this study, Jacobson et al used anonymous surveys distributed to recent dermatology resident graduates at a board examination review course to evaluate these gender differences. Women saw patients for fewer hours weekly than men, but spent more time practicing medical dermatology. Parenting status largely determined these differences.

Elliptical Excisions: Variations and the Eccentric Parallelogram

The primary linear closure of an elliptical (fusiform) excision is a crucial tool in cutaneous reconstruction. In this systematic review, Goldberg and Alam review the elliptical (fusiform) excision and critically assess the design, functionality, ease of construction, and cosmetic outcomes of variations of this traditional ellipse. The tangent-to-circle (rhombic) excision and the eccentric parallelogram are reviewed as alternative geometric variations that may prove useful in specific situations.

Number of Satellite Nevi as a Correlate for Neurocutaneous Melanocytosis in Patients With Large Congenital Melanocytic Nevi

Dysregulation within the normal migratory pathway of embryonic melanoblasts from the neural crest to the leptomeninges and skin can result in abnormal deposition and proliferation of melanocytes and melanin in the leptomeninges. Patients with large congenital melanocytic nevi (LCMN) are at greater risk for developing this neurocutaneous melanosis (NCM). Using data derived from an online LCMN registry, Marghoob et al offer further support that an increased number of satellite nevi surrounding an LCMN is a major risk factor for NCM, perhaps even more so than size alone.