Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Oct 2010
Expanding the spectrum of frontal fibrosing alopecia: a unifying concept.
In frontal fibrosing alopecia (FFA), scalp alopecia dominates the clinical picture. However, eyebrow loss and hair loss in other body sites may also occur; this has been documented clinically, but rarely histopathologically. We describe the clinicopathological findings of 13 cases of FFA, with histopathologic data from the scalp, eyebrow, and body hair. ⋯ Eyebrow and peripheral body hair loss is not uncommon in FFA-a finding that is likely underreported. We have demonstrated that alopecia of the upper limbs in FFA is indeed common and, histopathologically, shows features of lichen planopilaris and scarring, similar to findings in the scalp and eyebrows. Consequently, the process of lichen planopilaris with scarring alopecia is generalized rather than localized only to the frontal scalp and eyebrows.
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J. Am. Acad. Dermatol. · Oct 2010
Review Meta AnalysisSilver treatments and silver-impregnated dressings for the healing of leg wounds and ulcers: a systematic review and meta-analysis.
Previous systematic reviews of silver-impregnated dressings have been contradictory regarding the healing of leg wounds/ulcers. Our systematic review was restricted to randomized controlled trials. Cochrane Library, Scopus, and MEDLINE databases were searched using the term "silver" in combination with "wound" or "ulcer" (and plural versions) without date/language restriction. ⋯ Meta-analyses found strong evidence for wound healing based on wound size reduction but no evidence based on complete wound-healing or healing rates. Although our results provide some evidence that silver-impregnated dressings improve the short-term healing of wounds and ulcers, long-term effects remain unclear. Clinical trial data with longer follow-up times are needed to address these issues.
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J. Am. Acad. Dermatol. · Oct 2010
Comparative StudyThe integrity of the dermatology National Resident Matching Program: results of a national study.
National Resident Matching Program (NRMP) policy outlines the conduct expected by both program directors and residency applicants. However, recent studies and personal experiences have introduced the possibility that NRMP policy is violated during the residency application process. ⋯ Our data suggest that some dermatology program directors violate NRMP policy during their communications with applicants. The most widespread violation is pressuring applicants into revealing how they intend to rank programs. Other violations include apparent sexual discrimination and reserving NRMP positions for preselected applicants. Additional studies should be done in order to determine the incidence of dermatology applicants violating NRMP policy.
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J. Am. Acad. Dermatol. · Oct 2010
An analysis of health system reform for dermatologists: elements and implications of the Patient Protection and Affordable Care Act.
The Patient Protection and Affordable Care Act will have substantial effects on the US health care system. Physicians hold varied opinions regarding the overall merits or drawbacks of the health system reform law, but it is critical that we understand its components and the implications for our practices and our patients. This article describes the provisions most relevant to dermatology, analyzes the political and economic landscapes that shaped the legislation, and examines both opportunities and challenges that lie ahead. Physician leadership will be critical in future years as the regulations are written, the law is implemented, and legislative changes are considered.