Cutis
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Focal hyperhidrosis (HH) can cause debilitating reductions in the physical and emotional quality of life (QOL) of patients, which can result in numerous restrictions of a patient's personal and professional lifestyle and activities. A variety of treatment options are available for primary focal HH, including topical and oral agents, tap water iontophoresis (TWI), botulinum toxin type A (BTX-A), and surgery. Studies evaluating BTX-A (Botox) treatment for palmar, plantar, and facial HH reveal that BTX-A provides effective treatment of primary focal HH, with a reasonable duration of effect, and has a good safety profile. Physicians should understand the impact of focal HH and the need to stay abreast of the available treatment options to provide the best care for patients.
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Soft tissue augmentation is widely used to enhance or improve a patient's appearance. Hyaluronic acid is considered to be one of the best fillers for cosmetic procedures, mainly because of its lack of immunogenicity. We report a case of a persistent inflammatory reaction to injectable hyaluronic acid gel used for the correction of melolabial folds.
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Familial multiple lipomatosis (FML) is a rare entity. We report a family with this disease. ⋯ This is the first report of karyotypic analysis of lipomas removed from a patient with FML. The finding of a normal karyotype is important because approximately 25% of spontaneous lipomas will have abnormal karyotypes; therefore, we felt there was a significant probability that familial lipomas in FML would have abnormal karyotypes.
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Herpetic whitlow is a painful cutaneous infection that most commonly affects the distal phalanx of the fingers and occasionally the toes. It is caused by herpes simplex virus (HSV) types 1 or 2. ⋯ In children, most cases can be attributed to autoinoculation of HSV-1, while in adolescents and adults, herpetic whitlow tends to be caused by autoinoculation of HSV-2. Herpetic whitlow may have a prodrome of burning, pruritus, and/or tingling of the affected finger or the entire limb, followed by erythema, pain, and vesicle formation.
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Case Reports
Topical imiquimod therapy for basal and squamous cell carcinomas: a clinical experience.
Basal cell carcinomas (BCCs) and cutaneous squamous cell carcinomas (SCCs) are the most common malignancies in humans. Together, they constitute approximately 95% of nonmelanoma skin cancers (NMSCs). Surgical excision remains the mainstay of therapy of low-risk NMSC, though Mohs micrographic surgery is the gold standard for high-risk NMSC. ⋯ We also present a selection of representative case studies. Imiquimod cream 5% as adjunctive therapy to curettage was safe and well-tolerated in this mostly elderly population. The improved residual tumor and recurrence rates compared with historical rates for electrodesiccation and curettage (ED&C) alone suggest that adjunctive imiquimod therapy may be an appropriate treatment option for patients who desire or require less invasive treatment for NMSCs.