J Drugs Dermatol
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Psoriasis is an immunologic disorder mediated by T cells and proinflammatory cytokines. Novel biologic therapies, targeted at key pathogenic steps, have been developed and provide efficacy without the potential end-organ toxicity induced by traditional therapies. ⋯ This review has been prepared in 2 parts: Part 1 focuses on anti-TNF agents and includes new data that have become available through increased clinical experience and use in eligible patients. Part 2 will present new data on T-cell modulators, new molecules in development, and considerations for optimal therapeutic selection for treatment of patients with psoriasis (Journal of Drugs in Dermatology, March 2009).
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Comparative Study
Linear closure for nasal defects after Mohs micrographic surgery.
Skin cancers on the nose are very common. Excision of these tumors results in surgical defects that can pose a challenge to repair. ⋯ A vertical or slightly vertical linear closure for nasal defects after Mohs micrographic surgery is a robust and reliable method to deliver excellent cosmetic and functional results. Linear closure should be considered for small and mid-sized cutaneous nasal defects whenever possible.
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Isotretinoin is the most effective systemic treatment option for patients with nodulocystic acne or acne vulgaris who have failed a treatment with systemic antibiotics. ⋯ Almost one-fifth of patients have a recurrence of acne within the first 2 years. Patients should be made aware of this information, as it will contribute to the development of accurate and appropriate expectations of therapy.
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Idiopathic proctodynia, an enigmatic pain syndrome affecting the perianal region, can be persistent, relatively refractory to treatment, and associated with considerable psychological distress. The authors present the case of a patient with a long history of severe proctodynia that had been resistant to a range of topical and systemic treatments. With the use of topical amitriptyline hydrochloride 2.5% and ketamine hydrochloride 0.5% cream, the patient's pain resolved rapidly, leading to a substantially improved quality of life.
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Hyperpigmentation occurs in more than 37% of dark-skinned subjects treated with a fully ablative CO2 laser device. This study assessed the risk of postinflammatory hyperpigmentation (PIH) in subjects with skin types 4 and 5 treated once with a specific protocol of treatment using a fractional CO2 laser. ⋯ In dark-skinned subjects, fractional CO2 laser treatment and topical anesthesia subjectively improves common skin conditions without PIH.