Cutis
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The authors report a case of the sign of Leser-Trélat occurring in a patient with primary adenocarcinoma of the rectum. The patient demonstrated the sign several months before the internal malignancy was discovered. Although the majority of patients with the sign have an underlying adenocarcinoma of the gastrointestinal tract, relatively few cases have been reported with the rectum as the primary site. This case demonstrates a classic example of the sign of Leser-Trélat and illustrates its importance as a marker of underlying malignancy.
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Phytophotodermatitis is a phototoxic eruption following contact with photosensitizing compounds and long-wave ultraviolet light. The most common phototoxic compounds are the furocoumarins contained in a wide variety of plants, especially of the Umbelliferae, Rutaceae, and Moracea families. Commonly occurring photosensitizing plants include citrus fruits such as limes and oranges and many vegetables, notably celery, parsnip, parsley, carrots, and dill.
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Case Reports
Salicylate intoxication after use of topical salicylic acid ointment by a patient with psoriasis.
The authors describe a therapeutically well managed case of severe salicylate intoxication in a patient with psoriasis who treated himself with 40 percent salicylic ointment applied to approximately 41 percent of his body surface. Nineteen hours after the application of salicylic acid, his blood level of the agent was 6.04 mmol/liter. The patient underwent hemodialysis and was discharged after fourteen days in good general health.
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Twenty-four patients with notalgia paresthetica were treated with topical capsaicin (Zostrix) in a concentration of 0.025 percent for four months. In approximately 70 percent of the patients who remained in the study, relief of pruritus was achieved up to the 90 percent level. ⋯ The history, causes, and prevalence of the condition are reviewed. This treatment is the first described that is relatively effective.
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Accidental intravascular injection of lidocaine during the induction of infiltration anesthesia for dermatologic surgery is an occasional and harmless occurrence. The author noted nine such episodes in a three-year period of full-time private dermatologic practice. ⋯ Patients experienced no ill effects. The standard textbooks and reviews caution practitioners to aspirate before injecting a local anesthetic; this is unnecessary when performing infiltration anesthesia of the skin.