Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Nov 2004
Review Case ReportsRickettsialpox: report of three cases and a review.
Rickettsialpox is a rare mite-borne rickettsiosis that is encountered in urban populations in the eastern United States and throughout the world. It is characterized clinically by an eschar, fever, and a papulovesicular eruption. ⋯ It is thus important for clinicians to be familiar with rickettsialpox. We report 3 cases and review the epidemiology, clinical and laboratory findings, differential diagnosis, and management of this disease.
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J. Am. Acad. Dermatol. · Nov 2004
Review Case ReportsAcute lymphoblastic leukemia presenting with urticarial plaques and hypereosinophilia in a child.
Our report describes a previously healthy 10-year-old female who was seen for urticarial plaques and mild loss of appetite. An initial laboratory workup revealed an elevated leukocyte count of 30,000/microL and a peripheral eosinophil count of 22,500/microL. A skin biopsy showed a marked hypersensitivity tissue response with abundant eosinophils. ⋯ A bone marrow biopsy confirmed a diagnosis of acute lymphoblastic leukemia (ALL). ALL with hypereosinophilia (ALL/Eo) represents a rare and distinct subset of ALL, with more than 30 cases documented in the literature. Our discussion summarizes the clinical aspects of this disease and reviews the reported dermatological manifestations of ALL/Eo.
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J. Am. Acad. Dermatol. · Nov 2004
ReviewDigital anesthesia with epinephrine: an old myth revisited.
The prohibition against the use epinephrine with local anesthetics for digital blocks or infiltrative anesthesia is an established dogma in dermatologic surgery. Major textbooks reinforce this teaching suggesting that there is substantial risk of digital gangrene caused by local anesthesia containing epinephrine. ⋯ A literature review failed to provide evidence to support the dogma that block or infiltrative anesthesia with lidocaine and epinephrine produces digital necrosis. Proper injection technique and adequate selection of patients (absence of thrombotic, vasospastic conditions, or uncontrolled hypertension) are mandatory to minimize complications. The addition of epinephrine, in fact, reduces the need for the use of tourniquets and large volumes of anesthetic and provides better and longer pain control during digital procedures.
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J. Am. Acad. Dermatol. · Nov 2004
Case ReportsHypertrichosis of the eyelashes caused by bimatoprost.
The phenyl-substituted analog of prostaglandin F 2alpha , latanoprost (Xalatan; Pfizer, Inc, New York, NY) is an intraocular pressure (IOP)-lowering drug for use in patients with glaucoma and ocular hypertension. Latanoprost has been shown to stimulate eyelash hypertrichosis and has recently been proposed as a possible treatment for alopecia areata involving the eyelashes. We report a case of hypertrichosis of the eyelashes caused by the prostamide bimatoprost (Lumigan; Allergan, Inc, Irvine, Calif), a new IOP-lowering drug.
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J. Am. Acad. Dermatol. · Oct 2004
Randomized Controlled Trial Multicenter Study Clinical TrialInfliximab induction therapy for patients with severe plaque-type psoriasis: a randomized, double-blind, placebo-controlled trial.
Tumor necrosis factor-alpha is a key mediator in the pathogenesis of psoriasis. Infliximab is a monoclonal antibody that specifically binds to tumor necrosis factor-alpha, blocking its biologic activity. ⋯ Infliximab treatment resulted in a rapid and significant improvement in the signs and symptoms of psoriasis. Infliximab was generally well tolerated.