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This Month in Archives of Dermatology
Arch Dermatol. 2002;138:449.
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.
(SEE ARTICLE)
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.
(SEE ARTICLE)
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.
(SEE ARTICLE)
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.
(SEE ARTICLE)
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.
(SEE ARTICLE)
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.
(SEE ARTICLE)
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