Repair of the philtrum: an illustrative case series.

Background: Distortion of the philtrum, which lends considerable symmetry to the midface, leads to a poor esthetic outcome.

Objective: This case series describes reconstructive approaches to six philtral defects after Mohs micrographic surgery. Reconstructive approaches including advancement flaps, full-thickness skin grafts, and second-intention healing are illustrated.

What specialties perform the most common outpatient cosmetic procedures in the United States?

Background: The number of cosmetic procedures performed annually is on the rise and is being performed by more specialties.

Purpose: We sought to determine the relative outpatient cosmetic procedure experience of dermatology and other specialties. We also examined demographic data of patients who underwent cosmetic procedures.

Treatment patterns and cost of nonmelanoma skin cancer management.

Introduction: Nonmelanoma skin cancer (NMSC) is the most common form of cancer in the United States, more common than all other cancers combined. The factors that affect the cost of skin cancer management are not well defined.

Objective: The objective was to estimate cost of episodes of NMSC care and the factors that impact those costs.

Increase in procedures performed at dermatology office visits from 1995 to 2001.

Background: Over the past few decades, dermatologists have expanded the scope of their practice to include many surgical and cosmetic procedures in response to the development and demand for new procedures.

Objective: To examine the trend from 1995 in the proportion of dermatology visits associated with procedures to determine if there has been an increase in the number of procedures performed.

Methods: Data from the National Ambulatory Medical Care Survey were used to look at the proportion and types of dermatology visits associated with procedures performed during the years 1995 to 2001.

Tacrolimus ointment: utilization patterns in children under age 2 years.

Atopic dermatitis (AD) is a common eczematous skin condition; as many as 10-17 percent of all children are affected, and 35-60 percent of affected patients manifest symptoms manifest during the first year of life. Treatment principles for AD in young children involve conservative measures such as avoidance of hot water and environmental irritants, combined with liberal use of emollients after bathing. Low potency topical corticosteroids (TCS) are the current standard of therapy for AD in young children, reserving mid- and high-potency TCS for severe disease.

Surgical treatment of nonmelanoma skin cancer in the Medicare population.

Background: Nonmelanoma skin cancer (NMSC) is the most common malignancy of white populations. Different surgical treatment options can be used to treat these tumors, depending on the tumor characteristics and setting.

Objective: To determine how frequently different specialists use the different types of surgical options available for the treatment of NMSC using a 1998-1999 sample of Medicare claims data.

Effects of an episode of specialist care on the impact of childhood atopic dermatitis on the child's family.

Introduction: Although some preliminary work has examined the impact of atopic dermatitis (AD) on families, no empirical work has examined changes in the impact on families dealing with AD over time. An exploratory analysis of change in impact on families dealing with AD before and after an episode of medical care in a physician office setting was conducted.

Method: Baseline and follow-up surveys were completed by 35 parent caregivers before and 1 month after a dermatologist visit for the child at an academic medical center.

The use of 0.25% zinc pyrithione spray does not enhance the efficacy of clobetasol propionate 0.05% foam in the treatment of psoriasis.

Background: It was discovered that Skin Cap (Cheminova Internacional S.A., Madrid, Spain), an over-the-counter psoriasis therapy with zinc pyrithione, contained clobetasol propionate and it was withdrawn from the market by the US Food and Drug Administration review.

Nonmelanoma skin cancer: an episode of care management approach.

Background: The incidence of nonmelanoma skin cancers (NMSCs) was estimated at 1.3-million cases for the year 2000 and is on the rise. It is the most common form of cancer in the United States, more common than all other cancers combined.

Patients' vehicle preference for corticosteroid treatments of scalp psoriasis.

Topical therapy is one of the foundations of dermatology. The vehicles used to deliver topical therapy have considerable impact on efficacy. The vehicle can have direct effects on disease; it can impact the delivery of the active drug, and its characteristics affect patient compliance.

Skin cancer is among the most costly of all cancers to treat for the Medicare population.

Background: Compared with other malignancies, nonmelanoma skin cancer (NMSC) is associated with much less morbidity and mortality. NMSC is, however, far more common than other malignancies. The cost of managing NMSC has not been assessed.

The family impact of atopic dermatitis in children: the role of the parent caregiver.

Although some preliminary work exists examining the impact of atopic dermatitis (AD) in children on their families, there is no empirical work examining specific parent caregiver factors that could contribute to the family impact of this condition. We conducted a cross-sectional, exploratory analysis of how parent caregivers are affected by their child's AD, and how certain parent caregiver characteristics and perceptions affect the family impact of this condition. Parent caregivers of children with AD (n = 49) were administered a survey to collect detailed data on socioeconomic status, health perceptions, and caregiving issues.

Low-dose thalidomide therapy for refractory cutaneous lesions of lupus erythematosus.

Background: Thalidomide is an anti-inflammatory agent and an immunomodulator that inhibits the production of tumor necrosis factor alpha. It has shown promise as a treatment option for the cutaneous manifestations of lupus erythematosus (LE).

Objective: To assess the degree of clinical response per subtype of cutaneous lupus, the duration of therapy before documented clinical improvement, and the incidence of adverse effects, including peripheral neuropathy, with low-dose thalidomide therapy at 100 mg daily in the treatment of refractory cutaneous lesions of LE.

Patients with psoriasis prefer solution and foam vehicles: a quantitative assessment of vehicle preference.

Psoriasis patients' acceptance of the vehicles used in topical therapy contributes to adherence to treatment plans and outcomes, but patient preferences for different vehicles have not been assessed. The purpose of this study was to develop a quantitative measure of patient preferences for different vehicles and to assess these preferences. Focus group sessions were conducted of patients with psoriasis to determine patient perceptions of the advantages and disadvantages of different topical psoriasis therapies.

The safety of liposuction: results of a national survey.

Background: Liposuction procedures are increasing in frequency and may be performed in hospitals, ambulatory surgery centers, or physician offices. Deaths associated with liposuction and previous surveys of liposuction safety have raised concern about the safety of office-based surgery.

Objective: To determine the safety of office-based, tumescent liposuction among dermatologic surgeons.

Anecdotal reports of 3 cases illustrating a spectrum of resistant common warts treated with cryotherapy followed by topical imiquimod and salicylic acid.

Imiquimod is an immunomodulator with indirect antiproliferative and antiviral properties known to be effective against anogenital warts. However, its use for common warts has not been validated in prospective, controlled trials. We present 3 anecdotal case reports illustrating one treatment approach for a spectrum of resistant, common warts with combination therapy consisting of cryosurgery followed by administration of imiquimod and salicylic acid.

Follow-up survey of 308-nm laser treatment of psoriasis.

Background And Objectives: UVB treatment with a 308-nm excimer laser is a new treatment modality for localized psoriasis. The purpose of this study is to assess patients' impressions and satisfaction with 308-nm laser treatment of mild to moderate psoriasis.

Study Design/materials And Methods: Telephone survey data were obtained from patients after participation in a case series study of 124 patients with mild to moderate psoriasis treated with 308-nm UVB laser treatment for a target plaque and other lesions.

Efficacy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study.

Objective: Our purpose was to demonstrate the efficacy of the 308-nm excimer laser for treatment of psoriasis.

Methods: This study was a multicenter open trial from 5 dermatology practices (one university-based and 4 private practices). Up to 30 patients per center with stable mild to moderate plaque-type psoriasis constituted the study population.

Phototherapy utilization for psoriasis is declining in the United States.

Phototherapy is an established treatment modality for psoriasis. The use of phototherapy for psoriasis appears to be in decline in nonfederal and non-university-based settings. We used data from the National Ambulatory Medical Care Survey to estimate the number of visits for phototherapy and psoralen ultraviolet A-range (PUVA) light therapy from 1993 to 1998.