Nonmelanoma skin cancers of the ear: correlation between subanatomic location and post-Mohs micrographic surgery defect size.

Background: Nonmelanoma skin cancer (NMSC) of the ear can result in large defects with significant morbidity.

Objective: To determine whether subanatomic location of NMSCs, based on ease of visualization of the ear, correlated with post-Mohs micrographic surgery (MMS) defect size.

Methods: A retrospective chart review of 142 post-MMS ear lesions was performed and categorized according to subanatomic location: the helix, antihelix, and tragus (Location 1); retroauricular (Location 2); and conchal bowl, scapha, and triangular fossa (Location 3).

Treatment of lentigo maligna with imiquimod before staged excision.

Background: Imiquimod 5% cream has demonstrated effectiveness in the treatment of lentigo maligna (LM) in several small studies. None of the studies to date have included posttreatment surgical removal to confirm negative histologic margins.

Objective: The aim of this retrospective analysis was to assess the efficacy of topical imiquimod in LM by circumferentially examining vertically oriented sections from a geometrically designed "picture frame" margin as well as bread-loafed sections of the central portion after staged excisions of imiquimod-treated lesions of LM.

Cost-effective dynamic telepathology in the Mohs surgery laboratory utilizing iChat AV videoconferencing software.

Background: Dynamic telepathology is the real-time transmission of histologic images from one pathologist to another by means of telecommunications technology.

Objective: The objective was to determine whether dynamic telepathology can be accomplished accurately and inexpensively by use of readily available off-the-shelf consumer products and software.

Methods: We attached a standard, consumer-grade, digital video camera to a microscope in the Mohs surgery laboratory and then transmitted via the Internet real-time histologic video images and audio to a consultant dermatopathologist by means of iChat AV videoconferencing software (Apple Computer Inc.

Lentigo maligna/lentigo maligna melanoma: current state of diagnosis and treatment.

Background: Lentigo maligna (LM) is a subtype of melanoma in situ that typically develops on sun-damaged skin. Presentation may be quite subtle and delayed diagnosis is common. Clinical margins are often ill defined.

Alefacept: a novel biologic in the treatment of psoriasis.

Recognition of psoriasis as a T-cell-mediated immune disease has led to the development of various therapeutic approaches directed against the T cell and T-cell processes such as activation, trafficking and cytokine release. The novel and selective biologic agent alefacept, with an effect of selective apoptotic reduction in memory-effector T cells, has been given FDA approval for the treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy. The clinical profile of this novel biologic agent is presented here.

Dermatologic drug reactions.

Cutaneous drug reactions have a variety of clinical presentations. This review focuses on the most common or severe cutaneous reaction patterns. Knowledge of the clinical morphology and the most commonly associated medication aids in rapid diagnosis and institution of the appropriate therapy.

Argyria associated with colloidal silver supplementation.

A 65-year-old male presented for skin examination and was incidentally noted to have discoloration of the fingernails. These findings were completely asymptomatic. The patient had been taking colloidal silver supplementation (Silverzone 140 ppm silver Gifts of Nature, St.