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This Month in Archives of Dermatology
April 2002

This Month in Archives of Dermatology

Arch Dermatol. 2002;138(4):449. doi:10.1001/archderm.138.4.449

Pain Associated With Injection of Botulinum A Exotoxin Reconstituted Using Isotonic Sodium Chloride With and Without Preservative

Recent experience indicates that the stability of botulinum A exotoxin is not impaired by reconstitution using preservative-containing saline, and anecdotal reports suggest that such injections may be less painful for patients. In this prospective trial, Alam et al demonstrate that patient discomfort at the time of botulinum A exotoxin injection is markedly reduced in a manner that is statistically and clinically significant when the agent is reconstituted with preservative-containing saline. The reduced unpleasant sensation is not accounted for by differences in pH, but may be attributable to the anesthetic properties of benzyl alcohol.

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Axillary Fox-Fordyce Disease Treated With Liposuction-Assisted Curettage

Fox-Fordyce disease is characterized by small perifollicular papules localized to the apocrine gland-bearing regions. Medical therapy is often unrewarding for this chronic, pruritic condition. Chae et al describe a novel surgical approach that might be considered for recalcitrant Fox-Fordyce disease: eradicating the apocrine glands through liposuction-assisted curettage.

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Improved Differentiation of Benign and Malignant Lymphadenopathy in Patients With Cutaneous Melanoma by Contrast-Enhanced Color Doppler Sonography

Patients with malignant melanoma may be evaluated with lymph node ultrasound as part of either initial or follow-up examinations. This prospective study evaluated the use of a D-galactose–based contrast enhancer in patients who presented with suspicious structures during the B-scan ultrasound examinations. This contrast-enhanced color Doppler sonography gave additional sonomorphologic information that allowed improved differentiation of reactive lymph nodes, lymph node metastases, hematomas, and seromas.

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Definition of Axillary Hyperhidrosis by Gravimetric Assessment

Essential focal hyperhidrosis is characterized by excessive sweating of localized body areas, most commonly the axillae, palms, and soles. Patients may be quite distressed by this condition, but quantitation of the degree of affliction is often difficult and subjective. A novel gravimetric method of quantifying axillary sweat production is described by Hund et al, and the sweat production of patients suffering from disabling axillary sweating was compared with that of healthy control subjects. Suitable sweat production values are presented to objectively identify patients with axillary hyperhidrosis.

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Patients' Attitudes Regarding Physical Characteristics of Medical Care Providers in Dermatologic Practices

Despite a trend in Western society toward more casual dress styles, patients still expect health care professionals to look "professional." In this study, several characteristics of providers' dress and grooming were found to be important to patients, surprisingly revealing little attitudinal change from similar studies of 2 decades ago. To the extent that nonverbal communication such as physical appearance may play a role in direct interactions with patients, patients' improved comfort level with their dermatologist's appearance may be expected to improve physician-patient communication and overall patient care.

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Interferon Alfa-2a in the Treatment of Behçet Disease

Behçet disease (BD) is a chronic, relapsing, multisystem inflammatory disease of unknown etiology. A wide array of medical therapies has been used with varying degrees of success. This randomized, double-blind, placebo-controlled trial demonstrates that interferon alfa-2a may be an effective alternative treatment for the mucocutaneous lesions of BD by decreasing the duration and pain of oral aphthae and the frequency of genital ulcers and papulopustular lesions.

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