Simple modification to the punch biopsy technique to minimize handling and crush artefact.

A number of techniques have been described to retrieve the tissue core after punch biopsy. We describe a simple modification to the punch-biopsy technique that minimizes instrumentation, handling and the subsequent risk of crush artefact. Our technique is simple, quick and economical and essentially involves rotation of the punch through 90 degrees then lateral extraction with a degree of upward traction, which usually leaves the tissue core deposited beside the skin defect.

Tumid lupus erythematosus occurring following highly active antiretroviral therapy for HIV infection: a manifestation of immune restoration.

Tumid lupus erythematosus (LE) is a relatively rare and only recently recognized subset of chronic cutaneous lupus. We report a case occurring in a male with HIV infection whereby his rash was only unmasked by immune restoration following highly active antiretroviral therapy (HAART). The phenomenon of latent inflammatory or autoimmune disease appearing following HAART is now recognized as the "immune restoration syndrome" and tumid LE has not been reported in this setting previously.

Paraneoplastic immunobullous disease with an epidermolysis bullosa acquisita phenotype: two cases demonstrating remission with treatment of gynaecological malignancy.

Two cases of paraneoplastic immunobullous disease occurring in women with gynaecological malignancies are reported. Both cases demonstrated mechanobullous mucocutaneous blistering as is typically seen in epidermolysis bullosa acquisita. Their immunopathology, however, favoured a dermal-binding mucous membrane pemphigoid (MMP) (or possibly bullous pemphigoid) for patient 1 and laminin-5 MMP for patient 2.

Nodular melanoma. No longer as simple as ABC.

Background: Malignant melanoma is the fourth most commonly diagnosed malignancy in Australia. Nodular melanoma (NM) comprise less than 15% of all melanoma but account for up to 70% of those thicker than 3 mm.

Objective: This article describes the clinical features of NM, its prognosis and management.

Successful palliation and significant remission of cutaneous calcinosis in CREST syndrome with carbon dioxide laser.

Background: There are few satisfactory medical or surgical therapies for cutaneous calcinosis in connective tissue disorders.

Objective: Carbon dioxide laser vaporization allows precise ablation of superficial dystrophic calcification. This treatment modality was considered because of the severity of our patient's symptoms and failure to respond to various medical therapies.

Pachydermodactyly: a forme fruste of knuckle pads?

A 16-year-old boy presented with painless swellings localized to the radial and ulnar aspects of his second through to the fifth fingers on the left hand, with more subtle changes affecting two fingers on the opposite hand. This had developed in the absence of mechanical trauma. Investigations for an arthropathy were negative, while a biopsy showed marked epidermal hyperplasia and an expanded dermis.

Nodular melanoma: patients' perceptions of presenting features and implications for earlier detection.

Background: The incidence of thick melanoma and related mortality is largely static despite advances in early detection during the last 20 years. Nodular melanoma (NM) accounts for the majority of thick lesions and is difficult to recognize in the early stages of its evolution.

Objective: The purpose of this study was to identify historic or clinical features that may facilitate earlier detection of NM.

Photodynamic therapy: is it a valuable treatment option for actinic keratoses?

Photodynamic therapy (PDT) is proposed as an effective therapy with a good safety profile for patients with actinic keratoses. PDT involves the application of a photosensitizer to dysplastic or neoplastic tissue such that when exposed to light of an appropriate wavelength, the target tissue undergoes a cytotoxic reaction. Studies to date have demonstrated that PDT for the treatment of patients with actinic keratoses achieves clearance of lesions with minimal morbidity, maintenance of functional integrity of underlying tissues, and excellent cosmetic results.

Methods of evaluating hair growth.

For decades, scientists and clinicians have examined methods of measuring scalp hair growth. With the development of drugs that stem or even reverse the miniaturization of androgenetic alopecia, there has been a greater need for reliable, economical and minimally invasive means of measuring hair growth and, specifically, response to therapy. We review the various methods of measurement described to date, their limitations and value to the clinician.

Nodular type and older age as the most significant associations of thick melanoma in Victoria, Australia.

Objectives: To explore the clinical associations of thick melanoma and to compare the clinicopathological variables of nodular and superficial spreading types.

Design: Cross-sectional study of all invasive primary melanomas recorded by the Victorian Cancer Registry for 1998 and those reviewed by the Victorian Melanoma Service between October 1, 1994, and April 31, 1999.

Setting: Population-based cancer registry and public hospital-based multidisciplinary melanoma clinic.