Axillary Granular Parakeratosis.

We describe a case of an 85-year-old Caucasian female who presented to the dermatology clinic with pruritic, scaly hyperpigmented papules and plaques with surrounding erythema in the left axilla. Based on the history and physical examination, there was concern for possible varicella zoster infection, and the patient was started on valacyclovir 1000 mg three times daily for seven days. A shave biopsy was taken from the left axilla to confirm a diagnosis.

Serum Sickness-Like Reaction in an Adolescent Taking Minocycline for Acne.

We report a case of serum sickness-like reaction (SSLR) in a 14-year-old male taking minocycline for acne. The patient presented with urticarial rash, arthralgia/arthritis, and tender lymphadenopathy. Symptoms resolved with discontinuation of minocycline and treatment with prednisone, cetirizine, and ibuprofen.

Implementation and enforcement of tobacco bans in two prisons in North Carolina: a qualitative inquiry.

Despite the national trend that 90% of prisons have smoke-free indoors policies, compliance and enforcement remain barriers to policy success. Key informant interviews about policy compliance and enforcement were conducted with 10 staff and inmates at two North Carolina prison facilities, one with a complete ban (indoors and outdoors) and one with a partial ban (indoors only). Communication of the tobacco bans was consistent and well understood in both facilities.

Effect of salmeterol on mucociliary and cough clearance in chronic bronchitis.

The effect of long acting beta(2)-adrenergic bronchodilators on impaired mucociliary clearance in chronic bronchitis is unknown. Using a radiolabeled aerosol (technetium-99m-labeled sulfur colloid) and gamma camera analysis, we measured the acute effect of salmeterol vs. placebo on mucociliary and cough clearance in mild-moderate chronic bronchitics (n = 14) over a 2h period.

Assessing the need to update prevention guidelines: a comparison of two methods.

Background: An important concern for developers of clinical practice guidelines is how best to determine when guidelines require updating to ensure they remain current and evidence based. Because of the high costs associated with updating guidelines, recent attention has focused on approaches that can reliably assess the extent of updating required. Recently, Shekelle and colleagues proposed a model of limited literature searches with modest expert involvement as a way to reduce the cost and time requirements for assessing whether a guideline needs updating.