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Atopic dermatitis is a common problem affecting up to 10 percent of all children. The mainstays of therapy have been oral antihistamines, topical emollients, topical doxepin, and topical corticosteroids. Side effects associated with higher potency topical corticosteroids have limited their use in children and for facial areas. Tacrolimus (Protopic) is an immunosuppressive agent typically used systemically in transplant patients. Used topically, it has been found to be effective in treating moderate to severe atopic dermatitis without causing the atrophy that might occur with prolonged use of topical corticosteroids. Tacrolimus works equally well in children and adults, with more than two thirds of both groups having an improvement of greater than 50 percent. Despite its potency, very little of the medication is systemically absorbed, and absorption decreases as the atopic dermatitis resolves. The main side effects are burning and itching, but these also decrease with improvement of the atopic dermatitis. [ABSTRACT FROM AUTHOR]

Acne is a common problem in adolescents and young adults. The disorder is caused by abnormal desquamation of follicular epithelium that results in obstruction of the pilosebaceous canal. This obstruction leads to the formation of comedones, which can become inflamed because of overgrowth of Propionibacterium acnes. Topical retinoids such as tretinoin or adapalene are effective in many patients with comedonal acne. Patients with inflammatory lesions benefit from treatment with benzoyl peroxide, azelaic acid or topical antibiotics. Frequently, the use of comedonal and antibacterial agents is required. [ABSTRACT FROM AUTHOR]

Solitary pulmonary nodules are common radiologic findings, typically discovered incidentally through chest radiography or computed tomography of the neck, chest, and abdomen. Primary care physicians must decide how to pursue an evaluation of a nodule once it has been identified. The differential diagnosis for pulmonary nodules includes benign and malignant causes. Diameter of 8 mm or more, "ground-glass" density, irregular borders, and doubling time between one month and one year suggest malignancy. The American College of Chest Physicians recently released guidelines for the evaluation of solitary pulmonary nodules, based primarily on nodule size and patient risk factors for cancer. Algorithms for the evaluation of lesions smaller than 8 mm and those 8 mm or greater recommend different imaging follow-up regimens. Fluorodeoxyglucose-positron emission tomography can be used to aid decision making when cancer pretest probability and imaging results are discordant. Any patient with evidence of a nodule with notable growth during follow-up should undergo biopsy for identification. The rationale for closely monitoring an incidentally found pulmonary lesion is that detection and treatment of early lung cancer might lead to decreased morbidity and mortality.