Opioid Prescribing Recommendations After Mohs Micrographic Surgery and Reconstruction: A Delphi Consensus.

Background: Prescription opioids play a large role in the opioid epidemic. Even short-term prescriptions provided postoperatively can lead to dependence.

Objective: To provide opioid prescription recommendations after Mohs micrographic surgery (MMS) and reconstruction.

Non-Melanoma Skin Cancer Risk Among Patients in the Psoriasis Longitudinal Assessment and Registry (PSOLAR).

To the Editor: Patients with psoriasis are at increased risk of developing non melanoma skin cancer (NMSC), including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).1,2 The risk is especially elevated among those who previously received systemic treatment or phototherapy.2 Systemic treatments, including biologic therapies and methotrexate (MTX), are effective in managing immune-mediated diseases; however, they may increase susceptibility to NMSC due to immunosuppression or other factors.

Predictive value of biopsy specimens suspicious for melanoma: support for 6-mm criterion in the ABCD rule.

Objective: Clinical detection of melanoma can be challenging. The number of biopsy specimens performed to diagnose 1 melanoma is a measure of efficiency of skin cancer detection, but few data are available to describe this measure from US health care. We studied the diagnosis of melanoma among biopsy specimens of clinically concerning pigmented lesions at an academic dermatology department.

Facial allergic granulomatous reaction and systemic hypersensitivity associated with microneedle therapy for skin rejuvenation.

Importance: Microneedle therapy includes skin puncture with multiple micro-sized needles to promote skin rejuvenation or increase transdermal delivery of topical medications. In cosmetic practices, various cosmeceuticals are applied before microneedling to enhance the therapeutic effects. This results in intradermal tattooing of the topical product.

Chemoprevention of nonmelanoma skin cancer.

Chemoprevention is suitable for patients who are at high risk of development of numerous or invasive nonmelanoma skin cancers (NMSCs). Various substances have been studied as potential chemopreventive agents for NMSC. Oral retinoids have been proven to be effective in the suppression of new squamous cell carcinoma (SCC) development.

Intractable localized pruritus as the sole manifestation of intramedullary tumor in a child: case report and review of the literature.

Importance: Persistent localized pruritus is a rare manifestation of central nervous system tumors. Delayed diagnosis can lead to devastating complications.

Observations: We report an otherwise healthy 19-month-old girl who presented with signs of localized intractable pruritus of 6 months' duration on the left side of the neck, shoulder, and arm, resistant to systemic antihistamines and topical corticosteroids.

Clinical symptoms of skin, nails, and joints manifest independently in patients with concomitant psoriasis and psoriatic arthritis.

This study correlated assessment tools for evaluating the severity of skin, nail, and joint symptoms in patients with psoriasis (Pso) and psoriatic arthritis (PsA). Adults with plaque Pso (with or without PsA) were enrolled from four U.S.

Obesity in early adulthood as a risk factor for psoriatic arthritis.

Objective: To study whether obesity increases the risk of psoriatic arthritis (PsA), given that obesity is a risk factor for psoriasis and is associated with more severe disease.

Design: Case series. We used Cox regression analysis to study the relationship between obesity and PsA while controlling for age at psoriasis onset, current body mass index (BMI), sex, family history of psoriasis, worst-ever body surface area (BSA) involvement, Koebner phenomenon, and nail involvement.

Multiple Loci within the major histocompatibility complex confer risk of psoriasis.

Psoriasis is a common inflammatory skin disease characterized by thickened scaly red plaques. Previously we have performed a genome-wide association study (GWAS) on psoriasis with 1,359 cases and 1,400 controls, which were genotyped for 447,249 SNPs. The most significant finding was for SNP rs12191877, which is in tight linkage disequilibrium with HLA-Cw*0602, the consensus risk allele for psoriasis.

Association between IL13 polymorphisms and psoriatic arthritis is modified by smoking.

Genetic and environmental factors influence the development of psoriasis (Ps) and psoriatic arthritis (PsA). Recently, we reported that three IL13 polymorphisms, rs1800925, rs20541, and rs848, on chromosome 5q31 conferred the risk for Ps. IL13 encodes IL-13, a Th2 cytokine, and rs1800925 and rs20541 confer risk of asthma.

Bcl-xL gene expression correlated with lower apoptotic cell numbers and shorter progression-free survival in PCFCL.

The expression of bcl-x(L), an antiapoptotic member of the bcl-2 family, has been correlated with poor prognosis in nodal follicular lymphomas (NFLs). So far, it has not been studied in primary cutaneous follicle center lymphomas (PCFCLs), which, compared with NFLs, express less frequently t(14;18)(q32;q21) and bcl-2. Using real-time PCR we measured bcl-xL and bcl-2 gene expression levels in laser-microdissected lymphoma cells of 20 PCFCL frozen sections.

Cryotherapy for anogenital warts: factors affecting therapeutic response.

Human papilloma virus genital infection remains a treatment dilemma; there is still no gold standard therapy, treatment options are limited, expensive and often ineffective, and recurrence rates are relatively high. The primary objective of this study is to establish the efficacy, safety, and tolerability of cryotherapy in the treatment of these lesions. From 1999 to 2003, 100 consecutive patients with at least ten genital warts were treated with liquid nitrogen cryotherapy using a cotton-tipped applicator and two freeze-thaw cycles at the outpatient dermatology clinic of Hazrat-e Rasool University Hospital.

Skin tag as a cutaneous marker for impaired carbohydrate metabolism: a case-control study.

Background: Skin tags are common benign skin tumors usually occurring on the neck and major flexors of older people. A possible association with impaired carbohydrate metabolism has been suggested in previous studies, but the results are not conclusive.

Objective: To investigate and compare the prevalence of diabetes and impaired glucose tolerance (IGT) in patients with skin tag and a control group.

Clinical presentation and etiologic factors of hirsutism in premenopausal Iranian women.

Background: Hirsutism is a common clinical condition with different etiologies. Many of these patients have frank or subclinical abnormalities in the adrenal and ovarian steroidogenesis. The disease may be associated with other clinical signs of hyperandrogenism.

Expression of p53 in aggressive and non-aggressive histologic variants of basal cell carcinoma.

Basal cell carcinoma (BCC) generally has an indolent course but a subgroup of BCCs tends to grow aggressively into deep tissues and even metastasize. Although studies have shown a positive correlation between mutations in the tumor suppressor gene p53 and aggressive behavior in epithelial tumors, the results for BCC are conflicting. We aimed to determine whether there is any relationship between p53 expression in BCC and histopathologic subtype of the tumor.

Oral isotretinoin for acne, adjusting treatment according to patient's response.

Background: Oral isotretinoin is an established effective therapy for acne. No published data is available on the efficacy and side effects of this drug in Iranian patients.

Patients And Methods: A total of 132 acne patients with a mean age of 22.

Broad-band ultraviolet B phototherapy in zoster patients may reduce the incidence and severity of postherpetic neuralgia.

Background: Postherpetic neuralgia (PHN) is one of the common complications of herpes zoster infection, particularly in the elderly. Current therapeutic measures are only partially effective in the affected patients. As inflammatory mediators released by different cells play an important role in the pathogenesis of this neuropathic pain and with regard to the immunomodulatory effects of ultraviolet B (UVB) spectrum, we presumed that UVB phototherapy might be effective in the prevention of PHN.

Circumscribed juvenile-onset pityriasis rubra pilaris with hypoparathyroidism and brachyonychia.

Circumscribed juvenile-onset pityriasis rubra pilaris (PRP) manifests as well-defined erythematous scaly plaques with follicular keratosis mainly over the elbows and knees. There are several reports of the association of PRP with other conditions. We report a boy with scattered erythematosquamous skin lesions and follicular hyperkeratotic papules since he was 6 years old.

Scabies presenting with bullous pemphigoid-like lesions.

A wide range of clinical manifestations may be seen in scabies, from classic pruritic papules and burrows to secondary features such as impetigo. Bullus lesions are a less frequent. Twenty cases of scabies presenting with bullae have been reported so far in the medical literature.