Eruptive vellus hair cysts.

Eruptive vellus hair cyst (EVHC), described initially in 1977, is a benign dermatologic condition that is characterized by the sudden appearance of monomorphic, follicular, asymptomatic, small papules in children and young adults. The diagnosis is based on the histopathologic findings of stratified-squamous epithelium with a granular layer that surrounds a cystic space filled with laminated keratin and a variable number of vellus hair cysts. EVHC can be associated with steatocystoma multiplex.

Laser skin resurfacing, chemical peels, and other cutaneous treatments of the brow and upper lid.

The focus of this article is treatments of the brow and upper lid, in the context of appreciating their relationship to the forehead and periorbital complex to best evaluate and treat. This material is focused on treatments designed to stimulate collagen synthesis, as well as improve fine lines, wrinkles, and overall appearance of the skin, by mechanical dermabrasion, application of chemical peels, laser surgery, and treatment with energy devices including radiofrequency and focused ultrasound.

Chemical leukoderma.

Chemical leukoderma is defined as an acquired, hypopigmented dermatosis that results from repeated cutaneous application of an agent that destroys epidermal melanocytes in genetically susceptible patients. Chemical leukoderma may develop both at the site of contact with the chemical as well as remotely from the exposure. Avoidance of the causative agent may lead to spontaneous repigmentation, but treatments commonly used in vitiligo, such as narrow-band ultraviolet B phototherapy, PUVA photchemotherapy, or topical immunosuppressants, often are necessary.

Erythrodermic lichen planus.

Lichen planus (LP) is a relatively common papulosquamous disorder that is characterized by pruritic, polygonal papules in a characteristic distribution. We present a case of a 71-year-old man with erythroderma, who was ultimately diagnosed with severe, generalized LP. Treatment of severe LP is challenging, and there are few, robust, clinical trials in the literature to guide the selection of appropriate treatment.

Subcutaneous dematiaceous fungal infection.

Subcutaneous dematiaceous fungal infections, which include chromoblastomycosis and phaeohyphomycosis, are a heterogeneous group of clinical entities that are caused by dematiaceous or pigmented fungi found in soil. These infections have a wide spectrum of clinical presentations that depend largely on the specific causative organism and on the integrity of the host's immune response. Treatment is challenging and involves a highly individualized plan that often combines both surgical and long-term medical treatment.

Necrolytic acral erythema.

Necrolytic acral erythema (NAE) is a recently recognized dermatosis almost exclusively associated with hepatitis C virus (HCV) infection and closely related to a group of necrolytic erythemas and metabolic syndromes. NAE is characterized by pruritic, symmetric, well-demarcated, hyperkeratotic, erythematous-to-violaceous, lichenified plaques with a rim of dusky erythema on the dorsal aspects of the feet and extending to the toes. Based on morphology and histopathologic features, NAE can be difficult to distinguish from certain groups of necrolytic erythemas, which include necrolytic migratory erythema, acrodermatitis enteropathica, biotin deficiency, niacin deficiency, and essential fatty acid deficiencies.

Glomangioma.

A 22-year-old man presented with a 9-year history of multiple blue nodules on the medial aspect of his right arm. A biopsy specimen showed a cystic space with a cuboidal cellular lining that stained positive for α-smooth-muscle actin; these findings were consistent with multiple glomangiomas. We review the clinical and histopathologic characteristics of this rare entity.

Standing and exercise Doppler echocardiography in obstructive hypertrophic cardiomyopathy: the range of gradients with upright activity.

Background: The ideal provocative maneuver in patients with hypertrophic cardiomyopathy (HCM) is a subject of ongoing investigation. Standing is a fundamental activity of daily life. This study examined acquisition of standing, Valsalva, and post-exercise left ventricular outflow tract gradients in HCM.

Facial shaping: beyond lines and folds with fillers.

Facial attractiveness is the most important determinant of physical attractiveness, and an important factor in social and interpersonal interactions. The field of facial rejuvenation using minimally invasive procedures has expanded exponentially over the last decade. Historically, aging and the resulting changes were primarily attributed to changes in the skin and the underlying musculoskeletal system.

Enhancing the eyes: use of minimally invasive techniques for periorbital rejuvenation.

Facial beauty, specifically of the periorbital complex, is an important component of physical attractiveness and non-verbal communication, and is reflective of chronological age. In fact, eye contact is often the first, and some say the most important, form of interaction between individuals. These properties have made rejuvenation of the periorbital complex highly desirable.

Acute respiratory failure due to refeeding syndrome and hypophosphatemia induced by hypocaloric enteral nutrition.

We report a case of acute respiratory failure due to refeeding syndrome caused by hypocaloric enteral tube feeds. A 60-y-old obese man, with a diagnosis of esophageal carcinoma with local metastases, underwent feeding jejunostomy tube insertion. Enteral tube feeding was initiated at small volumes providing 4.

Autonomically induced conversion of pulmonary vein focal firing into atrial fibrillation.

Objectives: This study was designed to determine the mechanism(s) whereby focal firing from pulmonary veins (PVs) is converted into atrial fibrillation (AF).

Background: The mechanism(s) whereby PV focal firing or even a single PV depolarization is converted into AF is unknown.

Methods: In 14 anesthetized dogs a right thoracotomy was performed to expose the right superior pulmonary vein (RSPV).