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Background: It is known that malignant melanoma (MM) survivors are at increased risk of future primary MM. However, the risk for noncutaneous second primary malignancies (SPMs) is not as well‐understood. Methods: An observational study utilizing data from the Surveillance, Epidemiology, and End Results (SEER) database was performed, assessing data from patients diagnosed with primary cutaneous MM to measure overall, as well as specific, tumor type and risk of SPM. Results: Of the 132,438 patients recruited in the study population (mean age 55.5 years; 54% male), 23,794 SPMs were observed (O) (18% of patients at a mean age of 68.8 years), while 17,923 SPMs were expected (E) to occur (O : E 1.33, 95% CI 1.31–1.34). Excluding cutaneous MM occurring as a new primary malignancy, there was a significantly increased risk for SPMs among cutaneous MM survivors for each of the following tumor types: eye and orbit melanoma, tracheal, thyroid, salivary gland, retroperitoneum, small intestine, kidney, lymphoid and hematopoietic system, lymphoma overall, non‐Hodgkin lymphoma, lymphocytic leukemia overall, chronic lymphocytic leukemia, male genital system (including prostate), and breast. Certain gender‐specific trends for SPMs were also detected. Conclusions: Patients with primary cutaneous MM are at increased risk for primary noncutaneous MM as well as noncutaneous SPMs that include numerous tumor types. Enhanced oncologic surveillance for a variety of tumor types in melanoma survivors is warranted. [ABSTRACT FROM AUTHOR]

Objectives: A cleansing body wash containing diluted sodium hypochlorite (0.006% NaOCl) was evaluated for management of moderate‐to‐severe Staphylococcus aureus–colonized, atopic dermatitis in children. Methods: A 6‐week, prospective, open‐label study was conducted with 50 evaluable participants (ages 6 months to 17 years) who had moderate‐to‐severe atopic dermatitis with S aureus skin colonization documented by culture. Participants were instructed to continue using their current medications while using the study product, 0.006% NaOCl body wash, once daily to affected areas for 6 weeks. Primary outcome measures were Investigator's Global Assessment, Eczema Area and Severity Index, and Body Surface Area scores. Secondary outcome measures were the Visual Analog Scale for pruritus, Family Dermatology Life Quality Index, and Patient Satisfaction Questionnaire for Problem Areas. A subject daily diary and a six‐item subject questionnaire that provided information on preferences for bleach bath vs body wash were secondary outcome measures. Results: Daily use of the 0.006% NaOCl body wash led to improvement for all outcome measures comparing baseline to 2‐week and to 6‐week evaluations. Of the 50 skin S aureus‐positive subjects, 32/50 (64%) were still positive at 2 weeks. A 36.5% decrease in subject's daily record of topical corticosteroid application at end of study compared to baseline was found. Participant surveys indicated preferences for the body wash over bleach baths. Conclusions: Sodium hypochlorite (NaOCl) body wash improved all outcome measures for moderate‐to‐severe S aureus–colonized AD in infants, children, and adolescents. The limited reduction in S aureus further suggests that sodium hypochlorite has ameliorative effects other than antimicrobial actions. [ABSTRACT FROM AUTHOR]

Background Systemic biologic and nonbiologic agents used to treat psoriasis may or may not contribute to serious infection (SI) risk. Safety data, particularly for biologic agents, and associated risk for SI, are scarce. The study's aim was to explore the risk for SI in psoriasis patients exposed to systemic biologic or nonbiologic agents. Methods A large, single-center electronic medical record repository was searched between January 2010 and December 2014. Records for patients prescribed a systemic agent for psoriasis (SAP) with psoriasis or psoriatic arthritis diagnoses were included (ICD-9 codes 696.1 and 696.0, respectively). SIs were those who required hospitalization, and/or injectable antibacterial, antiviral or antifungal therapy. SIs occurring within 120 days after exposure to a SAP, were included for study. Results A total of 1,346 patients were exposed to a SAP between January 2010 and December 2014; 27 (2%) had a SI. Comparing biologic and nonbiologic agent exposure, no statistically significant difference for risk of SI was detectable ( p = .83). Conclusion In this population, the SI rate for biologic and nonbiologic systemic agents was clinically indistinguishable, thereby supporting consideration of the entire spectrum of available systemic therapeutic agents, both biologic and nonbiologic agents, for management of moderate to severe psoriasis. [ABSTRACT FROM AUTHOR]

Background/Objectives Epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis) includes immune-mediated, life-threatening inflammatory blistering disorders that can affect children. The Score of Toxic Epidermal Necrosis ( SCORTEN) tool has accurately predicted the outcome of these disorders in adults but has not been tested in children. Methods We performed a retrospective chart review to compare the accuracy of the adult SCORTEN tool with that of two modifications tailored to children in predicting disease outcome. Results The longer the patient's median length of hospital stay was, the higher the adult and two proposed pediatric SCORTENs were. In addition, all patients who died had SCORTENs greater than 4. Conclusion The pediatric-modified tools were not superior to the adult SCORTEN, which accurately predicted outcome. [ABSTRACT FROM AUTHOR]

Objective: To assess the validity of using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 710.3 to identify adult patients with dermatomyositis in outpatient and inpatient settings.Methods: Electronic medical records of adult patients with ICD-9 code 710.3 between January 2001 and November 2014 (n = 511) were examined. Physician diagnosis, clinical findings, and diagnostic testing results were recorded. A dermatomyositis rating scale was assigned based on classic cutaneous findings and at least 2 additional clinical and diagnostic findings from the Bohan criteria. Sensitivity and positive predictive values (PPVs) were determined. Sensitivity analyses were performed to evaluate the accuracy of multiple ICD-9 codes in the outpatient setting, as well as primary and secondary inpatient codes.Results: The sensitivity and PPV for multiple 710.3 ICD-9 codes in the outpatient setting were 0.89 and 0.35, respectively. The PPV for primary and secondary 710.3 inpatient codes was 0.95 and as high as 0.8. However, the sensitivity of ICD-9 code 710.3 was poor in the inpatient setting (primary 0.23 and secondary 0.26). The most common reason for failure to meet appropriate dermatomyositis criteria was miscoding as diabetes mellitus (32%), followed by diagnosis at an outside institution (19%), dermatomyositis as a rule-out diagnosis (10%), cutaneous dermatomyositis (8%), and juvenile dermatomyositis (6%).Conclusion: One or more occurrences of ICD-9 code 710.3 is insufficient to support the diagnosis of dermatomyositis in the outpatient setting. However, ICD-9 710.3 codes appear to be valid in the inpatient setting. [ABSTRACT FROM AUTHOR]

Background Current information indicates that psoriasis is a metabolic disorder with systemic manifestations. Reports have revealed an association between psoriasis and several chronic autoimmune disorders. For one of these disorders, Hashimoto's thyroiditis (HT), there are scarce, and relatively unconfirmed, reports of an association with psoriasis. We sought to determine if such an association is detectable in a large medical record data repository. Methods We searched one institution's electronic medical record data repository from January 2010 to December 2013. Patients were identified by ICD-9 codes (psoriasis: 696.0; 696.1, HT: 245.2). Only data from patients with laboratory-confirmed HT (anti-thyroid peroxidase [anti- TPO] antibodies; thyroglobulin antibodies; serum thyroid-stimulating hormone; and free T3) were eligible for inclusion. Logistic regression analysis was used to obtain an odds ratio ( OR) to establish an association between psoriasis and HT. Stratified analyses were performed to test for confounding variable and effect modification. Results Medical records for 856,615 individuals with documented encounters between January 1, 2010, and December 31, 2013, were detected. A total of 9654 had a diagnosis of psoriasis, and 1745 had a diagnosis of HT. Of these, 41 subjects were diagnosed with both conditions. A significant association existed for psoriasis and HT, even after adjusting for confounding variables that included gender, age, psoriatic arthropathy, and the use of systemic anti-psoriatic agents ( OR = 2.49; 95% CI 1.79-3.48; P < 0.0001). Conclusions This association has broad clinical impact and deserves further attention with regard to patient care, clinical research, and developmental therapeutics. [ABSTRACT FROM AUTHOR]

Background There is a lack of studies objectively comparing the efficacy of topical antiperspirants in reducing sweat. Objective To objectively and quantitatively compare the efficacy of two aluminum salt solutions for the reduction of induced sweating. Methods A subject, rater, and statistician-blinded, randomized, controlled trial. Nineteen subjects were exposed to a standardized heat challenge for 3 h. Topical agent A (20% aluminum chloride hexahydrate) was randomized to either axilla, and topical agent B (1% aluminum acetate) assigned to the contralateral side. A sauna suit induced sweating during three 30-min heat intervals: (1) with no study agents (pre); (2) with both study agents, one on each side; and (3) after the agents were washed off (post). Sweat levels were measured by securing Whatman® filter paper to each axilla and measuring the paper weight after each heat interval. The difference in paper weight following each heat interval between Study Agent A and Study Agent B was measured by a gravimetric scale. Results Topical agent A had a significantly greater effect at reducing axillary sweating than B (P = 0.0002). Conclusion In a sweating simulation, 20% aluminum chloride hexahydrate quantitatively and objectively appeared to reduce sweat more effectively than 1% aluminum acetate. [ABSTRACT FROM AUTHOR]

Background Forehead and glabella rhytides are treated mostly with neurotoxins, although some practitioners prefer the concurrent use of fillers. It has been suggested that combination treatments can result in a better overall improvement. Aims To compare the safety and effectiveness of treatment of forehead and glabellar lines with botulinum toxin A alone versus botulinum toxin A and filler. Methods Split-face, randomized control trial. Twenty subjects with forehead/glabellar rhytide complex (static and dynamic creases) enrolled. Subjects were randomized and injected with botulinum toxin alone on one side of the forehead/glabella and hyaluronic acid filler followed by botulinum toxin on the other side. Blinded ratings were obtained to assess the effectiveness of treatment for static and dynamic rhytides, respectively, at 2-week, 6-week, 3-month, and 6-month follow-up visits. Subjects performed a self-evaluation at the end of the study. Adverse events were recorded. Results Ratings of both treatments showed comparable efficacy, with 100% of subjects experiencing improvement from baseline regardless of treatment type at weeks 2, 6, and 12. Combination treatment produced longer-lasting results in dynamic forehead wrinkles, and greater static and dynamic wrinkle reduction in the glabella at week 24. Subject self-evaluations showed that both treatments were effective, with a nominal preference for combination treatment. Conclusions Glabella and forehead lines can be effectively and safely reduced with neurotoxin alone as well as neurotoxin in combination with fillers. Combination treatment may provide a slightly better cumulative benefit and also increase the persistence of effect. [ABSTRACT FROM AUTHOR]

BACKGROUND: Epidermal growth factor receptor (EGFR) inhibitors frequently result in dermatologic toxicities,including rash, xerosis, pruritus, and paronychia. Although the frequency and severity of these events have beendescribed, their effect on health-related quality of life (QoL) remains poorly understood. By using a dermatology-specific questionnaire, the authors examined the effect of these toxicities on QoL. METHODS: Patients completed theSkindex-16, a questionnaire that measures the effects on 3 domains of QoL: symptoms, emotions, and functioning.The severity of dermatologic toxicities was assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0 (NCI-CTCAE). Correlations of dermatology QoL scores with NCI-CTCAE grade,skin phototype (SPT), sex, age, type of EGFR inhibitor, and cancer type were investigated. RESULTS: Concordantwith greater severity of rash grade, there was an increase in median scores for symptoms (P = .0006), emotions (P <.0001), function (P = .001), and overall score (P < .0001). There was an inverse correlation between age and emotions(r = -0.26; P = .03) and overall score (r = -0.25; P = .04). There was a significant difference between patients aged50 years and patients aged >50 years with regard to symptoms (P = .02), emotions (P = .03), functioning (P =.04), and overall score (P = .02). There were no significant differences between QoL and SPT, sex, treatment type, orcancer type (P > .05). CONCLUSIONS: Toxicities, including rash, xerosis, paronychia, and pruritus, adversely affectedQoL, and rash was associated with a QoL greater decrease. Younger patients reported lower overall QoL than olderpatients who had the same toxicities. The current results support using the NCI-CTCAE as a correlative tool for measuring the effects of rash on dermatology-specific QoL. [ABSTRACT FROM AUTHOR]

There has been a dramatic sea change in the use of erythropoiesis-stimulating agents (ESAs) for anemic persons with chronic kidney disease (CKD) or cancer patients undergoing chemotherapy. An important area that has not been addressed previously is a CKD patient who also has a malignancy. Clinical guidelines exist that outline recommended treatments for each disease, but the intersection of the two disease processes presents difficult decisions for patients and physicians. Herein, we review the background underlying recent revisions in clinical alerts and guidelines for ESAs, and provide guidance for treating anemia among CKD patients who are receiving no therapy, chemotherapy with curative intent, or chemotherapy with palliative intent. The guiding principle is that comprehensive assessment of risks and benefits in the relevant clinical setting is imperative. [ABSTRACT FROM AUTHOR]

Highlights developments in contact dermatitis compiled as of April 2000. Occurrence of prurigo-nodularis-like lesions in patients with parthenium dermatitis; Clinical manifestations of allergic contact dermatitis from carrot; Relationship between depigmentation and paraphenylenediamine; Effect of natural rubber latex on allergic contact dermatitis.

Background. Long-term effectiveness of a dapsone compliance program was assessed in patients with leprosy. Methods. The monitoring program consists of urine dapsone/creatinine ratio determination at each visit with subsequent patient feedback and education. Eighty-eight patients receiving dapsone and seen in a leprosy clinic from 1985-1990 were included. Results. The proportion of patients compliant with dapsone during a given year ranged from 70.0% (1987) to 94.4% (1989). Overall compliance for the 6-year period was 81.6%. This level of compliance was significantly different (P < 0.05) than the baseline compliance in the leprosy clinic of 46.7%. Conclusions. Compliance monitoring, combined with active patient involvement, was effective in sustaining high compliance over a 6-year period. [ABSTRACT FROM AUTHOR]

The skin of preterm infants varies considerably in its level of maturity. To understand skin absorption in premature infants better, we report a technique for the assessment of percutaneous absorption at various gestational and postnatal ages using stable, isotope-labeled (13C6) benzoic acid. Our results indicate that in the preterm infant, this method detects enhanced skin absorption in the first postnatal days, which declines over three weeks to that expected of a full-term infant. This approach also indicates an inverse relationship between gestational age and skin absorption, as well as postnatal age and skin absorption. The reported technique is a safe and noninvasive method using a model skin penetrant for the study of percutaneous absorption in preterm infants from which basic data may be derived to add to our understanding of skin harrier function. [ABSTRACT FROM AUTHOR]

Studies the incidence of scabies in children through a high-magnification (HM) videodermatoscopy. Capabilities of HM videodermatoscopy; Identification of mites, migration burrows, eggs and feces from patients; Advantages in the use of HM videodermatoscopy.

The article focuses on the treatment of systemic lupus erythematosus in the U.S. Topics discussed include association of the disease with uncontrolled tumor cell proliferation; risk associated with the disease such as Non-Hodgkin's lymphoma, melanoma skin cancer, and Hodgkin's lymphoma; and highest incidence of teh same in midwestern U.S. patient population.