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Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007
Pompholyx is a common disorder characterized by recurrent crops of vesicles or bullae on the lateral aspects of the fingers, palms, and soles. In this prospective investigation of 120 consecutive patients with pompholyx, Guillet et al discovered a relevant allergic contact dermatitis as an etiologic factor in 67% of patients. Cosmetics and metals were the most frequently revealed allergens. Some patients were classified as having idiopathic pompholyx, but each of them was also atopic, suggesting that pompholyx could represent an equivalent of atopic palmoplantar dermatitis. Hyperhidrosis was observed in 33% of patients, suggesting that this represents an important cofactor.
The clinical presentation of psoriasis is heterogeneous. While 80% to 85% of patients have limited skin involvement, 15% to 20% have more extensive involvement that may require systemic therapy. In addition, psoriasis has been associated with multiple comorbidities that may increase the risk of mortality. In this population-based cohort study, Gelfand et al demonstrated a 50% increased risk of mortality among patients with severe psoriasis, as opposed to patients with milder psoriasis who had no elevated mortality risk. These data suggest that patients with severe psoriasis should receive comprehensive health assessments to enhance preventive health practices, improve overall health, and decrease the risk of mortality.
There is growing evidence that indoor tanning (IT) poses a serious public health risk, yet the IT industry continues to experience explosive growth, attracting more young people to tanning salons. In this cluster analysis, Hillhouse et al identified 4 tanning subtypes: event tanners, spontaneous or mood tanners, mixed tanners, and regular tanners. Event tanners tanned at moderate to low levels and had relatively low intentions to tan in the future. These casual tanners may be the most likely to be affected with appearance-related messages that might occur in clinical settings. Regular tanners tan at very high levels and were the most at-risk group. The mood component in this group suggested that they might benefit from screening for depression, seasonal affective disorder, body dysmorphic disorder, and substance-related disorders.
Common acquired melanocytic nevi (MN) typically develop individually on sun-exposed skin over the first 3 decades of life. The occurrence of eruptive MN is a rare phenomenon, characterized by the simultaneous abrupt onset of hundreds of nevi, often in a grouped distribution. In this case report, Gelfer and Rivers offer a long-term follow-up report on a patient who developed eruptive MN in the distribution of bullae secondary to Stevens-Johnson syndrome. Thirty-eight years after the development of these nevi, the lesions remained stable, with no evidence of malignant degeneration. The authors point out that eruptive MN during ongoing immunosuppression may not have a similarly benign course.
Original eruption on the back.
Given the added value of dermoscopy to the clinician, Scope et al hypothesize that dermoscopy might similarly benefit the pathologist examining excised specimens in identifying areas that were of concern to the clinician and in deciding how to section the lesion and where to focus histopathologic analysis. The orientation of the lesion, overall dermoscopic pattern, and dermoscopically pigmented structures were readily correlated between in vivo and ex vivo dermoscopic images, suggesting that dermoscopy can be applied to fixed tissues with findings similar to those of in vivo examination. This observation may serve as the first step toward using dermoscopy to guide tissue sectioning in gross pathology, and the authors propose a scheme for improving communications between clinicians and pathologists concerning pigmented lesions.
A 3-Year Causative Study of Pompholyx in 120 Patients. Arch Dermatol. 2007;143(12):1482. doi:10.1001/archderm.143.12.1482