Dermatologic clinics
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Dermatologic clinics · Oct 2010
ReviewClinical care of vulvar pruritus, with emphasis on one common cause, lichen simplex chronicus.
Vulvar pruritus is a common and distressing condition for patients, and its presentation is often delayed and complicated by home remedies. The true prevalence cannot be accurately estimated. ⋯ This is best accomplished by obtaining a careful history of vulvar care regimens and treatments, performing a detailed physical examination, and considering a broad differential diagnosis. This article provides a practical and clinical approach to the evaluation of vulvar pruritus and then focuses specifically on one common cause, lichen simplex chronicus.
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Pruritus remains a significant problem facing dermatologists and can be associated with various dermatoses and systemic derangements. At times, one can treat the underlying cutaneous or systemic process to alleviate itch. ⋯ In this article, the authors discuss the approach to a patient with generalized pruritus without clinically obvious dermatoses. They also addresses mechanisms and management modalities of itch in common systemic diseases, including cholestasis, uremia, and neuropathic dysfunction.
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Dermatologic clinics · Jul 2010
ReviewBiologic drugs for the treatment of hidradenitis suppurativa: an evidence-based review.
There are various treatment options for hidradenitis suppurativa (HS), a recurrent and suppurative disease, but none is wholly satisfactory or effective. There have been many reports on the efficacy of biologic drugs for the treatment of HS; this article is an in-depth review of the published evidence on this topic. Because the current evidence is limited, randomized, double-blinded, placebo-controlled trials are needed to better elucidate the future of these drugs for the treatment of HS.
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Among the severe genetic disorders of the skin that are suitable for gene and cell therapy, most efforts have been made in the treatment of blistering diseases including dystrophic epidermolysis bullosa. This condition can be recessively or dominantly inherited, depending on the nature and position of the mutation or mutations in the gene encoding type VII collagen. At present, there is no specific treatment for recessive dystrophic epidermolysis bullosa, and gene and cell therapy approaches hold great promise. This article discusses the different gene therapy approaches that have been used for the treatment of this disease and the new perspectives that they open.
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Patients with epidermolysis bullosa (EB) may present for anesthesia with an unrelated surgical condition or, more commonly, for diagnostic or therapeutic procedures. Children in particular may require frequent anesthetics. Safe and effective management of anesthesia presents a significant challenge and although there is little rigorous evidence available to aid decision-making, in this article the elements of current good anesthesia care in EB are summarized.