Scabies: Diagnostic and Therapeutic Update.

Background: Scabies is globally ubiquitous and is a significant health issue for institutions, the economically disenfranchised, resource-poor areas, and for those with weakened immune systems. Topicals are usually effective, but are cumbersome and expensive to use in large populations and for those nonadherent to topicals. Oral ivermectin became available in Canada for the off-label treatment of scabies in the fall 2018.

Solid carcinoma revisited: a possible variant of microcystic adnexal carcinoma.

Primary malignant apocrine and eccrine skin neoplasms are rare and their nosology is still evolving. First described in 1997, solid carcinoma is now considered a discrete entity by some, although this remains controversial. Apocrine differentiation was postulated.

Update on intralesional steroid: focus on dermatoses.

Background: Intralesional steroid (ILS; usually triamcinolone acetonide) is commonly used, and the literature contains much information about its use in keloids, hemangiomas, and alopecia areata. Little has been written about its use in inflammatory dermatoses such as psoriasis and localized dermatitis since the 1960s, the conditions for which it was originally most studied and used.

Objective: To clarify the use of ILS and to encourage its use in psoriasis and localized dermatitis.

Ethyl chloride spray for sensory relief for botulinum toxin injections of the hands and feet.

Background: Botulinum toxin injections are effective in the treatment of palmar and plantar hyperhidrosis, but discomfort has limited its use.

Objective: To study the use of ethyl chloride medium-stream spray in reducing injection discomfort.

Methods: We used ethyl chloride medium-stream spray, in conjunction with precooling by frozen ice packs, in our No Sweat Clinic for our most recent 51 consecutive cases of botulinum toxin injection.

Side effects of short-term oral corticosteroids.

Background: Physicians frequently prescribe short-term corticosteroids (CSs) to treat acute and self-limiting diseases. Standard texts and articles do not usually discuss the possible, although infrequent, risks of short-term CSs.

Objective: To demonstrate that side effects, although uncommon, can occur with short-term CSs and that these can occasionally be serious.

Short-term corticosteroids and avascular necrosis: medical and legal realities.

Short-term corticosteroids (CSs), most commonly defined as short-term prednisone (STP) 40 to 60 mg or its equivalent, either tapered or level, prescribed over a few days to 3 weeks (total dose, 400-600 mg), often are used to treat acute and self-limiting diseases. Serious side effects, though uncommon, can occur; however, they receive little attention. The literature contains scattered case reports and legal cases that highlight the relationship between STP and avascular necrosis (AVN).