Cutis
-
Review Case Reports
Acute hemorrhagic edema of infancy: case reports and a review of the literature.
Acute hemorrhagic edema of infancy (AHEI) is an unusual form of leukocytoclastic vasculitis that affects children younger than 2 years and frequently is preceded by drug intake, vaccination, or a variety of infections. It is characterized by an abrupt onset of fever, purpuric lesions, and peripheral edema on the face and extremities that may be confused with other dermatoses. The course is benign with spontaneous resolution. We present 2 infants with AHEI and review the clinical manifestations, histology, and differential diagnosis.
-
A major issue in treating acne in individuals of color is the need to treat and prevent postinflammatory hyperpigmentation (PIH), which is common in this population. This subset analysis reports the pigmentary changes in subjects of color with acne who were enrolled in a community-based trial comparing 3 different topical therapeutic regimens. ⋯ Subjects were randomized to receive this combination therapy in addition to either a tretinoin microsphere (RAM) gel at concentrations of either 0.04% or 0.1% or adapalene (AP) gel 0.1%. There was a trend toward better resolution of hyperpigmentation in the subjects receiving the clindamycin-BPO topical gel in combination with RAM gel 0.04%.
-
Review
Status update: hospital-acquired and community-acquired methicillin-resistant Staphylococcus aureus.
Methicillin-resistant Staphylococcus aureus (MRSA) is a common bacterial pathogen that has long been considered a hospital-acquired pathogen. However, newer community-acquired strains have appeared that differ from nosocomial strains in their susceptibility to different antibiotics. ⋯ A variety of antibiotics are available for the treatment of hospital-acquired MRSA (HAMRSA) and community-acquired MRSA (CAMRSA). Incision and drainage is of paramount importance in the treatment of cutaneous abscesses and is sufficient treatment in most uncomplicated skin and soft tissue infections.
-
Antimicrobial prophylaxis is rarely appropriate for dermatologic surgery. Dermatologic procedures seldom cause bacteremia, and they have been implicated as a cause in only an extremely small number of cases of endocarditis or infections of vascular grafts or orthopedic prostheses. ⋯ Topical antibiotic ointments for that purpose are ineffective. Whether prophylactic antivirals are helpful in preventing herpes simplex infections after facial resurfacing is uncertain.
-
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.