Search

Objectives: This study aims to review the spectrum of scarring that may present to an urban, pediatric otolaryngology practice and determine if associations exist between race, scar location, treatment modality, and outcomes following interventions for scarring. Methods: Retrospective cohort study among 115 pediatric patients with 138 unique keloids or hypertrophic scars (HTS), and 141 children presenting for tonsillectomy at Tufts Medical Center. Age at presentation and sex assigned at birth were collected for both populations. For those presenting for pathologic scars, income quintile, self‐identified race/ethnicity, anatomical location, treatment number and type, and clinical outcome were also analyzed. Multivariate analyses calculated adjusted odds ratios (aORs) and 95% confidence intervals to assess associations between scar subsite, intervention type, and persistence after treatment. Results: Compared to individuals presenting for tonsillectomy, a disproportionate percentage of patients presenting for scarring identified as Black (26.6% vs. 13.5%) or Asian (17.4% vs. 7.1%, p = 0.016) or were male (61.7% vs. 49.7%, p = 0.053). Individuals identifying as Black or Asian were more likely to present with ear lobe and neck scars, respectively (50.0% vs. 45.5%, p = <0.001). Ear scars were significantly more likely to receive excision at initial treatment (aOR = 5.86 [1.43–23.96]) compared to other subsites, and were more likely to require >1 treatment (aOR = 5.91 [1.53–22.75]). Conclusion: Among pediatric patients presenting with keloids or HTS, children who identified as Black or Asian were more likely to present with ear and neck scars, respectively. Ear scars were frequently treated with excision and appear more likely to require adjuvant treatments and multiple interventions. Level of Evidence: 3 Laryngoscope, 134:3127–3135, 2024 [ABSTRACT FROM AUTHOR]

BackgroundThe current NCCN recommendation for resection margins in patients with melanomas between 1.01 and 2 mm deep is a 1-2 cm radial margin. We sought to determine whether margin width had an impact on local recurrence (LR), disease-specific survival (DSS), and type of wound closure.MethodsMelanomas measuring 1.01-2.0 mm were evaluated at a single institution between 2008 and 2013. All patients had a 1 or 2 cm margin.ResultsWe identified 965 patients who had a 1 cm (n = 302, 31.3 %) or 2 cm margin (n = 663, 68.7 %). Median age was 64 years, and 592 (61.3 %) were male; 32.5 and 48.7 % of head and neck and extremity patients had a 1 cm margin versus 18.9 % of trunk patients (p

Nontuberculous mycobacterial lymphadenitis (NTML) is a common cause of subacute and chronic cervicofacial masses in children under 5 years of age (Fig.). Gl Current management options include observation, directed antibiotic therapy, fine needle aspiration (FNA), incision and drainage (I&D), curettage, and complete surgical excision. Primary or adjuvant clarithromycin and rifampin have demonstrated some efficacy against NTM, requiring a minimum duration of 6 to 8 weeks but often extending much longer with varying success rates.[4] Most reports, including infectious disease literature, favor complete surgical excision of NTML, with antibiotic therapy reserved for children in whom surgical excision is incomplete or who recur.[[2], [4]] LITERATURE REVIEW Numerous studies of pediatric NTML describe management options including observation, antibiotic therapy, and incomplete or complete surgical excision of the involved NTM lymph nodes. [Extracted from the article]

Background: Currently, dermatology residency training requires minimal experience in cosmetic procedures which can be achieved through observation. Objective: To assess education in and expectations for cosmetic procedures during dermatology residency. Materials and Methods: A 20-question survey was electronically distributed to 138 Accreditation Council for Graduate Medical Education-accredited dermatology residency training programs. Results: One hundred fifty surveys were returned. While 74 percent of the responding residents reported plans to integrate cosmetic procedures into their future practice, only 36 percent felt adequately trained. Forty-eight percent of residents received one or less didactic lectures annually. Over 95 percent of residents felt that a more formal curriculum in cosmetic procedures would benefit residency education. Conclusion: There appears to be insufficient didactic and clinical training in cosmetic procedures during dermatology residency to meet resident expectations and future practice habits. [ABSTRACT FROM AUTHOR]

Tattoo popularity continues to rise, with 3 in 10 Americans bearing at least one. Among tattoo complications, non-tuberculous mycobacteria (NTM) has emerged as a global public health concern. NTM infections associated with tattooing of immunocompetent individuals have occurred as sporadic cases and community outbreaks. Water sources are considered the major pathogenic reservoirs. Tattoorelated inoculation has been linked to contamination of ink, either during the manufacturing process or during dilution of black ink using non-sterile water. NTM infections have also been documented in a number of cosmetic and surgical procedures, including cutaneous surgery, Mohs micrographic surgery, mesotherapy, liposuction and laser resurfacing. NTM inoculation through exposure to contaminated water or non-sterile instruments remains a challenge for dermatologists and risk to patients. We reported a case of cutaneous Mycobacterium massiliense infection following tattoo placement. This report underscores the importance of clinicians to consider NTM infections in the differential diagnosis of procedure-related reactions. [ABSTRACT FROM AUTHOR]

A 72-year-old white man presented to the clinic with a tender, pruritic lesion on the upper part of his left arm that had progressively worsened over 4 months. Physical examination revealed an erythematous to violaceous, indurated, and sclerotic plaque with multiple foci of crusting and erosions (Figure 1). The patient denied any recent trauma, travel, fever, chills, weight loss, or constitutional symptoms. Before presentation, he had undergone treatment with cephalexin, prednisone, and doxycycline without reported improvement. Laboratory studies were negative for antinuclear antibody and SCL70 antibody; however, an absolute eosinophilia of 1478/uL was noted.

The first patient was a 41-year-old white man who was referred to the dermatology clinic with a 2-year history of numerous erythematous, hypoesthetic, poorly demarcated papules and plaques present on the trunk, buttocks, and bilateral upper and lower extremities (Figures 1 and 2). The lesions had initially begun as localized erythematous plaques on the right flank, and were diagnosed and treated as cellulitis and allergic contact dermatitis by primary care on separate occasions, with no resolution and continued gradual but persistent spread.

Cutaneous squamous cell carcinoma (cSCC) is the most common skin cancer diagnosed in African Americans. 1 Twenty to forty percent of cSCCs reported in African Americans are related to chronic scarring processes or areas of in ammation. 2 Risk factors for developing cSCCs in patients of color include chronic scars resulting from burns, skin ulcers, and radiation sites; and chronic inflammatory diseases such as discoid lupus and hidradenitis suppuritiva. 1 Although skin cancer only accounts for 1% to 2% of cancers diagnosed within African Americans, it is associated with increased morbidity and mortality in this population. 1,3 Significant delays in diagnosis and treatment are largely thought to be responsible for this prognostic incongruity. The rate of metastasis in patients of color is 31%, compared with only 4% in Caucasians. 4,5 Early recognition by physicians and increased awareness resulting in preventative measures by patients may decrease this noted disparity. J Drugs Dermatol. 2016;16(1):81-84..