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This Month in Archives of Dermatology
Arch Dermatol. 2002;138:734.
Regression of Urticaria Pigmentosa in Adult Patients With Systemic
Mastocytosis: Correlation With Clinical Patterns of Disease
Urticaria pigmentosa (UP) may be associated with systemic disease. This
associated systemic mastocytosis may be indolent or may be associated with
a hematologic disorder. What is the natural history of systemic mastocytosis
in those patients in whom the UP regresses? On review of the records of 106
patients with adult onset UP, Brockow et al found that, in patients with mastocytosis
with an associated hematologic disease, regression of UP may occur even as
the bone marrow disease becomes progressively more severe. However, in patients
with indolent mastocytosis, regression of the UP often parallels regression
of the systemic disease.
(SEE ARTICLE)
Celecoxib, a Cyclooxygenase 2 Inhibitor as a Potential Chemopreventive
to UV-Induced Skin Cancer: A Study in the Hairless Mouse Model
Any UV-induced prostaglandin synthesis and up-regulation of cyclooxygenase
2 (COX-2) may contribute to the initiation and promotion of skin carcinogenesis.
Celecoxib is a selective COX-2 inhibitor that is a commonly prescribed nonsteroidal
anti-inflammatory agent. In this randomized, dose-response study, Orengo et
al demonstrate that SKH hairless mice fed therapeutic doses of celecoxib had
dramatically fewer UV-B–induced tumors, suggesting an exciting new therapeutic
approach to the chemoprevention of skin cancers.
(SEE ARTICLE)
Aggressive Squamous Cell Carcinomas in Persons Infected With the Human
Immunodeficiency Virus
Patients infected with human immunodeficiency syndrome (HIV) can live
longer and healthier lives than ever before. While previous studies have demonstrated
an increased incidence of squamous cell carcinomas (SCCs) among HIV-infected
patients, this retrospective case series demonstrates for the first time the
aggressive nature of these tumors. Patients with long-standing HIV disease
may develop rapidly growing SCCs at a young age, with an increased risk of
local recurrence and metastases. The finding that these tumors present a higher
morbidity and mortality than HIV disease itself points out the need for early
and aggressive therapy for these high-risk malignancies in the setting of
immunosuppression.
(SEE ARTICLE)
Product-Related Emphasis of Skin Disease Information Online
An exponentially increasing number of users are logging onto the World
Wide Web to access medical information. Despite this increased demand the
validity and reliability of patient-related Web sites remain uncertain. A
number of groups, including the American Medical Association, have developed
rating instruments for Web-based medical sites, but these instruments have
not been widely validated or used. Using several search engines, Hu et al
demonstrate that most Web sites retrieved from typical search strategies for
dermatology-related key words contained product-oriented material rather than
educational information, and that the search engine ranking may be easily
misinterpreted by patients as an expression of quality.
(SEE ARTICLE)
Sun Protection Policies and Environmental Features in US Elementary
Schools
Skin cancers are epidemic, and evidence suggests that childhood sun
exposure plays a critical role in cutaneous carcinogenesis. In this random
survey of public elementary schools in the United States, only 3.4% of schools
had a policy with rules or recommendations designed to improve sun protection.
The most common reason cited for not having a policy was the school principal's
lack of awareness of the problem. These findings offer a logical starting
point for developing and promoting sun protection policies in schools.
(SEE ARTICLE)
Mediation of Systemic Vascular Hyperpermeability in Severe Psoriasis
by Circulating Vascular Endothelial Growth Factor
Vascular endothelial growth factor (VEGF) is locally produced by lesional
psoriatic tissue but is also released into the systemic circulation where
it exerts potent microvascular permeability activity, particularly in the
kidneys and lungs. Creamer et al demonstrate that markedly elevated plasma
VEGF levels, as well as pathologic proteinuria, accompany generalized pustular
psoriasis. Plasma VEGF analysis in patients with severe psoriasis may represent
a useful predictor of clinical outcome.
(SEE ARTICLE)
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