Treatment of acne vulgaris in pregnant patients.

The management of acne vulgaris in the setting of pregnancy raises important clinical considerations regarding the efficacy and safety of acne treatments in this special patient population. Particular challenges include the absence of safety data, discrepancy in safety data between different safety rating systems, and lack of evidence-based recommendations for the treatment of acne during pregnancy. Nonetheless, many therapeutic options exist, and the treatment of acne in pregnant women can be safely and often effectively accomplished.

Calcium may preferentially deposit in areas of elastic tissue damage.

Background: Cutaneous calcification is an acquired disorder whereby insoluble, amorphous calcium salts deposit in the skin. Classically, cutaneous calcification is categorized as metastatic, dystrophic, idiopathic, or iatrogenic.

Objective: The purpose of this study was to further elucidate the underlying pathogenic mechanism for cutaneous calcification.

Phototherapy in pediatric patients: choosing the appropriate treatment option.

Phototherapeutic modalities, including narrowband-UVB, broadband-UVB, PUVA photochemotherapy, and excimer laser therapy are valuable tools that can be used for photoresponsive dermatoses in children. As a systematically safer alternative compared with internal agents, including the prebiologic and biological therapies, phototherapy should be considered a possible treatment option for children with diseases including psoriasis, atopic dermatitis, pityriasis lichenoides chronica, and vitiligo.

Broadband UVB revisited: is the narrowband UVB fad limiting our therapeutic options?

Broadband ultraviolet B (BB-UVB) phototherapy has demonstrated efficacy in the treatment of cutaneous disorders including psoriasis, atopic dermatitis, uremic pruritus and idiopathic pruritus. In the last decade, there has been a rapidly escalating process of replacing BB-UVB phototherapy units with narrowband ultraviolet B (NB-UVB) equipment, as studies have demonstrated that NB-UVB (ranging from 311 mm to 312 nm) is more efficacious in the treatment of psoriasis. Nevertheless, it is important to recognize the efficacy of BB-UVB phototherapy in the treatment of uremic pruritus, idiopathic pruritus, eosinophilic folliculitis and other inflammatory pruritic conditions.

Pilot evaluation of supra-erythemogenic phototherapy with excimer laser in the treatment of patients with moderate to severe plaque psoriasis.

Background: Phototherapy is an effective treatment for generalized plaque psoriasis, but is inconvenient and dosimetry is limited by the minimal erythema dose (MED).

Objective: This pilot study evaluated the efficacy, safety, and feasibility of excimer laser utilizing a supra-erythemogenic phototherapy strategy (phototherapy well beyond the MED dose) to treat generalized psoriasis.

Methods: In this 9-month study, 13 patients with psoriasis involving > 10% but < 30% body surface area received laser treatment twice weekly for 12 weeks, with 6 months of post-treatment follow-up.

Practice of phototherapy in the treatment of moderate-to-severe psoriasis.

This chapter will discuss the entire spectrum of phototherapy, including narrowband UVB photo-therapy, broadband UVB phototherapy, PUVA, targeted excimer laser phototherapy, and combination treatments. Phototherapy can range from simple treatments in a UVB phototherapy box, with or without concurrent use of various tar preparations, to more elaborate modalities in which the intensity of UVB radiation applied varies according to different anatomical regions. Combining PUVA or UVB phototherapy with topical and systemic agents can also enhance phototherapy.

Dermal mucinosis as a sign of venous insufficiency.

Dermal mucinoses are a heterogeneous group of disorders characterized by abnormal deposition of dermal mucin, an amorphous substance composed of hyaluronic acid and sulfated glycosaminoglycans. We describe two cases of dermal mucinosis in the setting of chronic venous insufficiency. Both patients presented with painful, edematous lower extremity plaques.

Efalizumab discontinuation: a practical strategy.

Efalizumab is a recombinant, humanized IgG1 monoclonal antibody used in the treatment of plaque psoriasis. Efalizumab specifically targets T cells, leading to the subsequent inhibition of T-cell activation. The recent cases (three confirmed and one unconfirmed but suspected case) of the demyelinating disease progressive multifocal leukoencephalopathy (PML) have resulted in efalizumab being pulled from the market by European and Canadian regulatory agencies.

Occlusive therapy in atopic dermatitis: overview.

Introduction: Occlusive therapy, including both dry and wet ('wet-wrap therapy') offers a treatment option in atopic dermatitis (AD) which may be underutilized in clinical practice due to concerns about burdensome regimens and potential complications. This review examines current evidence for the use of occlusion in AD.

Methods: Keyword and title searches in PubMed and EMBASE were used to examine data on the use of occlusive therapy in AD from January 1966 to February 2009.