Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Aug 2007
Assessment of quality of life in patients with primary axillary hyperhidrosis before and after suction-curettage.
Focal axillary hyperhidrosis (FAH) is a benign functional disorder that may lead to social and psychologic handicap. Hence, the improvement of quality of life is a major aim of therapy. Several studies evaluating the quality of life before and after application of topical agents, injections with botulinum toxin, and thoracoscopic sympathectomy have been reported. However, changes of quality of life after minimally invasive surgical procedures such as suction-curettage (SC) have not been investigated so far. ⋯ Our data support results of previous studies demonstrating that FAH is associated with considerably reduced quality of life. SC is an effective surgical therapy option that can largely reverse the disabilities experienced by patients with excessive axillary sweating.
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J. Am. Acad. Dermatol. · Jun 2007
Randomized Controlled Trial Multicenter StudyTreatment of pruritus with topically applied opiate receptor antagonist.
Pruritus is the most common and distressing skin symptom, and treatment of itch is a problem for thousands of people. The currently available therapies are not very effective. Therefore there is an urgent need to find new effective topical drugs against itching. ⋯ The placebo-controlled study showed a significant advantage of topically applied naltrexone over the placebo formulation. This finding is supported by the biopsy results from the open studies, showing a regulation of MOR expression in epidermis after treatment with topical naltrexone, especially in atopic dermatitis. These results clearly show potential for topically applied opioid receptor antagonist in the treatment of pruritus. The placebo formulation also had some antipruritic effects. This underlines the importance of rehydration therapy for dry skin in the treatment of pruritus.
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J. Am. Acad. Dermatol. · May 2007
Sensitivity, specificity, and diagnostic accuracy of three dermoscopic algorithmic methods in the diagnosis of doubtful melanocytic lesions: the importance of light brown structureless areas in differentiating atypical melanocytic nevi from thin melanomas.
Over the past decade numerous epiluminescence microscopy (ELM) criteria and algorithmic methods have been developed to improve the diagnosis of cutaneous melanocytic lesions. ⋯ The pattern analysis method showed the highest sensitivity, specificity, and diagnostic accuracy for TM. Light brown structureless areas were both a statistically significant discriminator and the most reliable predictor of TM (PPV = 93.8%, positive likelihood ratio = 16). Therefore the use of this previously underestimated ELM criterion may not only improve diagnostic performance of equivocal macular melanocytic lesions but also significantly decrease the rate of false-negative results obtained with the 7-point checklist method.