Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Mar 2009
Randomized Controlled TrialA randomized, double-blind comparison of the total dose of 1.0% lidocaine with 1:100,000 epinephrine versus 0.5% lidocaine with 1:200,000 epinephrine required for effective local anesthesia during Mohs micrographic surgery for skin cancers.
We sought to compare total lidocaine dose and patient comfort when using 1.0% lidocaine with 1:100,000 epinephrine versus 0.5% lidocaine with 1:200,000 epinephrine during Mohs micrographic surgery. ⋯ The dose of 0.5% lidocaine with 1:200,000 epinephrine provides pain control equivalent to 1.0% lidocaine with 1:100,000 epinephrine at approximately half the total lidocaine dose.
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J. Am. Acad. Dermatol. · Feb 2009
Case ReportsInflammatory plaque with peripheral nodules: a new specific finding of cutaneous polyarteritis nodosa.
Cutaneous polyarteritis nodosa commonly affects the distal lower limbs, presenting as nodules, ulcers, and livedo reticularis. We report five cases to illustrate a new specific presentation of cutaneous polyarteritis nodosa on the trunk or proximal extremities. In the acute stage, lesions were tender erythematous plaques. ⋯ Systemic polyarteritis nodosa did not develop in any patient after a follow-up time ranging from 9 months to 9 years. The presence of small nodules at the periphery of an inflammatory plaque was a useful clinical clue, because this prompted us to suspect cutaneous polyarteritis nodosa when we encountered similar cases later, which could be confirmed histologically. In conclusion, cutaneous polyarteritis nodosa can present as inflammatory plaques on the trunk and proximal extremities, and the presence of peripheral nodules around these plaques constitutes a useful clinical clue to its diagnosis.
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J. Am. Acad. Dermatol. · Jan 2009
ReviewMinimally invasive techniques in the treatment of saphenous varicose veins.
Lower extremity venous insufficiency is common and increases with age. In addition to classical symptoms, it may result in skin changes and venous ulcers. Chronic venous insufficiency has a great impact on patients' health-related quality of life and is associated with considerable health care costs. ⋯ Dermatologists have played an important role in the development of these new therapies of truncal varicose veins. Of the new therapies, ultrasound-guided foam sclerotherapy, endovenous laser therapy, and radiofrequency ablation are the most common and challenge surgery as the "gold standard" of care for patients with varicose veins. The objective of this review is to inform clinicians about these 3 therapeutic options for truncal varicose veins and to describe and compare the procedures, indications, efficacy, and safety profile.
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J. Am. Acad. Dermatol. · Jan 2009
A gender gap in the dermatology literature? Cross-sectional analysis of manuscript authorship trends in dermatology journals during 3 decades.
Despite a dramatic influx of female dermatologists during the last 30 years, women in academic dermatology departments remain relatively clustered in junior faculty positions. Research in other specialties showing a disparity in the academic productivity of women has led to many hypotheses regarding factors that may place them at a competitive disadvantage. It is unknown, however, whether similar differences in academic productivity might also serve as barriers to advancement in dermatology, or whether any productivity gap actually exists in this specialty that experienced a more substantial entry of women. ⋯ Female dermatologists are authoring publications in growing numbers that match or exceed their prevalence in the academic and overall workforce. This suggests that other factors (differences in productivity outside of the publishing arena, differences in job descriptions or opportunities, differences in career aspirations, a lack of institutional support or flexibility, or gender bias) may be associated with the ongoing reduced advancement of women to senior academic dermatology ranks relative to their male colleagues, and further research is warranted to explore these possibilities.