Using en face ink to guide the conservative sectioning of a Mohs margin.

Background: While the epidermal rim of a Mohs layer routinely requires some manipulation, the deep margin seems to conform easily to a smooth surface for sectioning even when tissue textures and contours are prominent. How well these common features of the deep margin flatten during processing has not been well studied.

Objective: To determine how successfully tissue processing flattens the deep margin of Mohs specimens.

Modifying the Burow's triangles of traditional transposition flaps for the repair of adjacent nasal defects.

Background: Adjacent defects are commonly encountered during Mohs micrographic surgery for nasal skin cancers and often present a formidable reconstructive challenge.

Objective: This article will describe similar modifications of both the bilobed and nasolabial transposition flaps' Burow's triangles that allow for the repair of two adjacent defects of the distal nose using a single flap.

Methods: This is a report of two similar reconstructive cases after Mohs micrographic surgery requiring the repair of adjacent nasal defects.

The tissue efficiency of common reconstructive design and modification.

Background: Facial reconstructive techniques are capable of restoring a normal anatomic appearance despite the tissue loss resulting from skin cancer removal. Because none of these techniques recreate the lost tissue, most of these techniques require the removal of additional normal tissue in the form of Burow's triangles to achieve this goal.

Objective: To analyze the quantity and potential variability of redundant tissue loss encountered during the use of conventional reconstructive techniques through the calculation of tissue efficiency.

The density and distribution of melanocytes adjacent to melanoma and nonmelanoma skin cancers.

Background: The determination of clear margins during Mohs surgery for melanoma in situ arising on sun-damaged skin is often made difficult by the presence of background atypical melanocytic hyperplasia.

Objective: To determine the density and distribution patterns of melanocytes adjacent to melanoma and nonmelanoma skin cancers.

Methods: 180 skin specimens obtained during the routine repair of defects resulting from the removal of melanoma and nonmelanoma skin cancers were analyzed using H and E-stained permanent sections to determine the quantity and distribution of epidermal melanocytes.

Treatment of basal cell carcinoma with curettage alone.

Background: Although curettage and electrodesiccation (C&E) is widely used to treat basal cell carcinoma, whether electrodesiccation improves outcome is unknown.

Objective: We sought to compare cure rates of curettage alone with those of C&E.

Methods: We conducted a retrospective records review of patients treated with curettage alone at 5-year follow-up or longer that extracted data about tumor location, size, histologic subtype, biopsy specimen margin involvement, and recurrence, as well as data about the medical history of patients treated in a dermatology clinic in a tertiary-care academic medical institution.

Prescribing practices for seborrheic dermatitis vary with the physician's specialty: implications for clinical practice.

The prescribing practices of different medical specialties (dermatology, family medicine, pediatrics and other) for seborrheic dermatitis were analyzed using the National Ambulatory Medical Care Survey (NAMCS). The frequency of use of various antifungal and anti-inflammatory medications was found to differ greatly between specialties, with the greatest difference being seen between dermatologists (who frequently prescribe the antifungal ketoconazole) and non-dermatologists (who most frequently prescribe corticosteroids).

Changes in tolerance to rectal distension correlate with changes in psychological state in patients with severe irritable bowel syndrome.

Objective: Reduced tolerance to rectal distension has been regarded as a biological marker for irritable bowel syndrome (IBS), but longitudinal studies are few. This study determined whether change in tolerance to rectal distension after psychological treatments was associated with: 1) change in abdominal pain; 2) change in psychological symptoms; 3) a reported history of sexual abuse.

Methods: Participants completed a visual analogue scale of abdominal pain, SCL-90 and Hamilton rating scale of depression; discomfort threshold to rectal distension was determined using a double random staircase protocol.

The specialty of the treating physician affects the likelihood of tumor-free resection margins for basal cell carcinoma: results from a multi-institutional retrospective study.

Background: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Surgical experience and physician specialty may affect the outcome quality of surgical excision of BCC.

Methods: We performed a multicenter retrospective study of BCC excisions submitted to the respective Departments of Pathology at 4 major university medical centers.