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This Month in Archives of Dermatology
Arch Dermatol. 2002;138:579.
Mad Cows, Prions, and Wrinkles
Considerable public concern exists regarding the safety of bovine-derived
products, especially after the mid-1980s epidemic of bovine spongiform encephalopathy
in England. Potential human exposure to transmissible spongiform encephalopathies
exists in some cosmetic injectables. However, this review reassures dermatologists
and patients of the extremely high safety profile of the currently available
injectables.
(SEE ARTICLE)
In the United States, Blacks and Asian/Pacific Islanders Are More Likely
Than Whites to Seek Medical Care for Atopic Dermatitis
Population-based studies suggest an increase in prevalence of atopic
dermatitis in black and/or Asian children. National Ambulatory Medical Care
Survey data reveal that these groups are much more likely to visit physicians
for atopic dermatitis than are whites. The genetic, cultural, and environmental
factors that may contribute to this increased incidence and prevalence are
discussed, as are strategies for early intervention based on these factors
in these potential target populations.
(SEE ARTICLE)
Successful Treatment of Cutaneous Sarcoidosis Using Topical Photodynamic
Therapy
Sarcoidosis is a multisystem disease with well-recognized clinical and
radiologic features, characterized pathologically by the formation of noncaseating
granulomas in many organs, including the skin. No consistently effective therapy
for sarcoidosis exists. Karrer et al describe a novel therapeutic approach
to sarcoidosis using topical photodynamic therapy with 5-aminolevulinic acid,
which achieves dramatic results for a patient with previously recalcitrant
cutaneous lesions of sarcoidosis.
(SEE ARTICLE)
Raynaud Phenomenon and Behçet Disease: Diagnosis With Technetium
Tc 99m Methylene Diphosphonate Bone Scan and Treatment With Continuous Sympathetic
Block
Önder et al describe the unusual association of Behçet disease
and Raynaud phenomenon coexisting in the same patient. Three-phase bone scintigraphy
was performed, during which early blood pool phase images revealed decreased
tracer uptake in this patient's second, third, and fourth fingers. This hypoperfusion
improved significantly following continuous sympathetic block.
(SEE ARTICLE)
Psoriasis as a Model for T-Cell–Mediated Disease: Immunobiologic
and Clinical Effects of Treatment With Multiple Doses of Efalizumab, an Anti–CD11a
Antibody
Leukocyte function–associated antigen 1 (LFA-1) plays an important
role in T-cell activation through its interaction with intercellular adhesion
molecule 1. This interaction presents an attractive therapeutic possibility
for T-cell–mediated diseases such as psoriasis. In this study, Gottlieb
et al used a monoclonal antibody directed toward the CD11a subunit of LFA-1.
Intravenous administration of this monoclonal antibody to patients with moderate
to severe psoriasis resulted in substantial disease improvement.
(SEE ARTICLE)
Reliability of the Histopathologic Diagnosis of Malignant Melanoma
in Childhood
Malignant melanoma (MM) is rarely diagnosed in childhood, and when it
is, unusual clinical and histologic features often complicate the diagnosis.
The distinction between MM and Spitz nevi or pigmented spindle cell nevi remains
one of the most difficult problems facing dermatopathologists. Wechsler et
al recruited 8 dermatopathologists to review slides, and the interrater reliability
in the diagnosis of MM in children was assessed. The concordance of diagnoses
among pairs of experts was generally only poor to moderate, suggesting that
the reliability of the pathologic diagnosis of MM in childhood is poor, even
in the hands of experts.
(SEE ARTICLE)
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