Leukemia cutis in B-cell chronic lymphocytic leukemia presenting as an episodic papulovesicular eruption.

A 53-year-old man presented with a recurrent pruritic eruption accompanied by oral sores. His past medical history was significant for subclinical B-cell chronic lymphocytic leukemia (CLL), which had never been treated. On exam, there were erythematous papules and plaques studded with vesicles on the neck, trunk, and upper extremities.

Predictive value of café au lait macules at initial consultation in the diagnosis of neurofibromatosis type 1.

Objective: To evaluate the predictive utility of the number and morphologic appearance of isolated café au lait macules (CALMs) in establishing the diagnosis of neurofibromatosis type 1 (NF1) in a cohort of children referred to an NF1 subspecialty clinic.

Design: Retrospective study of patients seen between the years 2004 and 2007.

Setting: Tertiary care neurofibromatosis referral clinic at St Louis Children's Hospital.

Current management of onychomycosis.

Onychomycosis is the most common single cause of nail dystrophy and has a marked impact on quality of life. The availability of newer topical and systemic antifungal agents has improved our ability to effectively treat this condition. This article will review the most commonly used therapies and discuss the relative advantages and disadvantages of different treatment strategies.

Nonsurgical treatment modalities for primary cutaneous malignancies.

Background: Various modalities have been available to treat primary cutaneous malignancies. Although not indicated for certain aggressive tumors, many of the newest regimens involve noninvasive techniques. It behooves both the nonsurgeon and the surgeon alike to be apprised of all treatment options, their indications, and their efficacy.

Off-label uses of biologics in dermatology: rituximab, omalizumab, infliximab, etanercept, adalimumab, efalizumab, and alefacept (part 2 of 2).

Recently, dermatologists have witnessed a revolution in our therapeutic armamentarium with the development of several novel biologic immunomodulators. Although psoriasis remains the only condition in dermatology for which the use of biologic immunomodulators has been approved by the Food and Drug Administration, these drugs have the potential to significantly impact the treatment of several inflammatory conditions in dermatology. This article includes a review of the mechanism of action, dosing, and side-effect profile, as well as a review of the current literature on off-label uses of the CD20-positive B-cell antagonist rituximab, the IgE antagonist omalizumab, the tumor necrosis factor-alpha antagonists infliximab, etanercept, and adalimumab, and the T-cell response modifiers efalizumab and alefacept.