Virtually painless local anesthesia: diluted lidocaine proves to be superior to buffered lidocaine for subcutaneous infiltration.

Background: Many physicians believe that buffering local anesthetics with sodium bicarbonate is the best technique for reducing the pain and discomfort associated with subcutaneous infiltration.

Objective: To compare the level of pain and discomfort associated with subcutaneous infiltration of lidocaine diluted with normal saline to that associated with traditionally buffered lidocaine.

Patients/methods: In a prospective, double-blind trial, 31 patients were asked to use a visual analog scale to rank the level of pain and discomfort caused by two different solutions of lidocaine with epinephrine.

Nail damage from gel polish manicure.

Manicures can result in nail damage via instrumentation, nail polish, nail polish removers, and artificial nails. We report nail weakness, brittleness, and thinning in five subjects after the application of a new manicure system called gel polish and removal with acetone and manual peeling. All subjects complained that the polish was very difficult to remove and that their nails became much thinner after the procedure.

A pilot study to determine the safety and efficacy of monochromatic excimer light in the treatment of vitiligo.

Background And Objective: According to a European pilot study, the 308-nanometer (nm) Excilite mu (DEKA, Florence, Italy) system may be a promising tool for patients with vitiligo by offering targeted phototherapy, a rapid onset of repigmentation, and few adverse effects. The objective of this study was to evaluate the clinical efficacy and safety of the 308-nm Excilite mu in the treatment of vitiligo. METHODS AND LIMITATIONS: Ten patients with stable vitiligo were exposed to 10 weeks of targeted phototherapy with the Excilite mu device, followed by 5 weeks of observation.

Predictors of skin cancer screening practice and attitudes in primary care.

Background: Physician visits provide invaluable opportunities to screen patients for skin cancer, yielding earlier detection and improved survival.

Objective: We sought to assess frequency of skin cancer screening by full body skin examinations (FBSE) by primary care physicians, patient attitudes toward FBSE, and risk factors for cutaneous malignancy.

Methods: Questionnaires were distributed to patients at primary care and dermatology clinics.

Neck injuries caused by automatic two-point seat belts: an analysis of four cases.

Although seat belts significantly reduce the extent and severity of injuries sustained by motor vehicle occupants, seat belts are known to be associated with chest and abdominal trauma. Less commonly understood are severe neck injuries caused by the use of two-point automatic shoulder harnesses without concurrent use of a manual lap belt. Such injuries may include cervical spine fractures, craniocervical dislocations and rarely decapitation.