Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Jan 2012
ReviewSarcoidosis: Are there differences in your skin of color patients?
The skin of color population is growing at an astronomical rate, making it critically important to recognize diseases, such as sarcoidosis, in patients with skin of color. Sarcoidosis is a multisystem, granulomatous disease, which manifests in a variety of organs and is found more frequently in Blacks as compared with Caucasians. ⋯ Sarcoidal lesions can present with multiple morphologic features, some more common in patients with skin of color. We offer a review of the cutaneous presentations of sarcoid lesions in patients with skin of color, an overview of extracutaneous sarcoidosis, the cutaneous signs that may impact overall disease prognosis, and treatment options.
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J. Am. Acad. Dermatol. · Jan 2012
Characteristics of medical professional liability claims against dermatologists: data from 2704 closed claims in a voluntary registry.
The Physician Insurers Association of America established a voluntary registry in 1985 that contains 239,756 closed claims. The registry is maintained for educational programs to reduce patient injury and medical professional liability (MPL) claims. ⋯ MPL issues are important to all practicing dermatologists. The most common allegation against dermatologists in this study was improper performance of operative procedures on the skin, excluding skin grafts. Error in diagnosis of malignant melanoma was the next most common allegation. Malignant melanoma claims were paid in 42.2% of cases with an average indemnity payment of $436,843. By focusing on the risk management of these procedures and this diagnosis, dermatologists can have the largest impact on reducing patient injuries and consequent MPL claims.
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J. Am. Acad. Dermatol. · Jan 2012
EditorialTime for a change? Updated guidelines using interferon gamma release assays for detection of latent tuberculosis infection in the office setting.
Treatment with tumor necrosis factor-alfa inhibitors and other systemic medications increases the risk of reactivating a latent tuberculosis (TB) infection. Therefore, screening for latent TB infection is important in dermatology patients eligible for treatment with these medications. ⋯ Although there are situations when either test may be performed, in individuals who have received a BCG vaccination and in those who are unlikely to return for a TST reading, IGRAs may be particularly helpful in distinguishing patients at risk for TB. This article discusses the advantages and disadvantages of both the TST and the IGRA and presents a summary of the Centers for Disease Control and Prevention 2010 guidelines for using IGRAs.
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Trips abroad to underdeveloped countries for the purpose of providing dermatologic care (medical missions), while both exciting and gratifying, require planning and forethought. What do I bring? What conditions will I encounter? What medications will be available? This paper outlines my experiences on such trips over the past 15 years, providing an approach and formulary which facilitates the performance of daily medical dermatology clinics.
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The 2001 anthrax attacks on the United States brought bioterrorism to the forefront of the medical community. Because many bioterrorist agents produce cutaneous disease, dermatologists will likely be first responders during a future attack. ⋯ It is critical that all first responders be able to recognize symptoms of bioterrorism-related disease and prepared to respond to a bioterrorist attack to minimize threats to public health. This article reviews the diagnosis and treatment of diseases caused by potential biowarfare agents that produce cutaneous manifestations, and also provides information regarding reporting and containment of possible bioterrorism-related diseases.