J Drugs Dermatol
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Randomized Controlled Trial Comparative Study
A comparative study evaluating the tolerability and efficacy of two topical therapies for the treatment of keloids and hypertrophic scars.
Onion extract gel (OE) and 0.5% hydrocortisone, silicone and vitamin E lotion (HSE) are two over-the-counter preparations used to enhance the cosmesis of keloids and hypertrophic scars. ⋯ Both OE and HSE were more effective than placebo in the management of hypertrophic scars and keloids.
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Erythromelalgia is a rare chronic disorder characterized by intense burning pain, redness, swelling and increased skin temperature. It occurs primarily in the feet, but may also involve the hands, face and ears. Warming of the extremity or placing and maintaining the extremity in a dependent position can exacerbate symptoms. ⋯ Although a specific therapy is not available for erythromelalgia yet, several treatment modalities may be used as therapeutic options, including: aspirin, indomethacine beta-blockers, calcium channel antagonists, misoprostol, diltiazem, tricyclic antidepressants, serotonin reuptake inhibitors and number of more aggressive procedures--such as intravenous lidocaine, epidural anaesthesia, intrathecal opiates and sympathetic ganglion blockade. There are very few reports in the literature of gabapentin successfully treating erythromelalgia. Here, the authors report a case of primary erythromelalgia in a 20-year-old woman responding to gabapentin therapy.
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Methyl aminolevulinic acid photodynamic therapy (MAL-PDT) has antitumor activity and may promote wound healing Superficial and nodular basal cell carcinomas (BCCs) have been successfully treated with MAL-PDT in prior reports. In vitro and animal studies have shown more rapid re-epithelialization and decreased myofibroblast response after treatment thus suggesting that PDT may play a possible role in promotion of wound healing. ⋯ MAL-PDT may be an effective adjuvant tool against large multifocal BCCs for which surgery has not resulted in clearance. Treatment with PDT resulted in rapid re-epithelialization of the surgical wound in this case. This observation is supported by prior in vitro studies and in vivo animal experiments demonstrating more rapid re-epithelialization of wounds and decreased scarring response after PDT.
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This article is a review of this winter's common infections and their treatments. As infectious agents become more aggressive and more resistant, new medications are needed to fight them. The recent outbreak of the H1N1 ("swine flu") influenza strain has increased, by several-fold, the use of the oral antiviral Tamiflu (oseltamivir) and Relenza (zenavimir). -As resistant skin and soft-tissue infections increase in frequency, the use of newer antibiotics is becoming more common. This article reviews the use and cutaneous side effects of antivirals and new antibiotics with a focus on those relevant to the dermatologist.
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Review Comparative Study
Cost effectiveness of Mohs micrographic surgery: review of the literature.
A number of treatment modalities are currently in existence for non-melanoma skin cancer, including microscopically controlled surgical excision (e.g., Mohs micrographic surgery [MMS]), traditional surgical excision, radiation therapy, electrodessication and curettage, cryosurgery, photodynamic therapy and topical chemotherapeutic agents. MMS has the significant advantage of the lower recurrence rates of all treatment modalities, where five-year cure rates for MMS for primary BCCs are 1% relative to surgical excision (10.1%), electrodessication and curettage (7.7%), radiation therapy (8.7%) and cryotherapy (7.5%). Previous studies have also indicated, across specialties, that dermatologists have the highest rates for complete removal of non melanoma skin cancer (NMSC) which are significantly greater than those for otolaryngologists (P>0.02) and plastic surgeons (P<0.0008). ⋯ Analysis of the existing literature on MMS relative to surgical excision confirms the value of MMS in both obtaining the highest initial cure rates and lowest recurrence rates. This analysis confirms that MMS is a cost effective treatment, which is lower in cost than surgical excision, which often includes an ASC facility fee and a subsequent re-excision procedure. Cost effectiveness analysis demonstrating the outcomes based efficiency of MMS are critical in the current health care climate with heightened sensitivity to financial pressures and declining reimbursement rates which may challenge our ability to provide patients with the optimal treatment for NMSC.