International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients With Psoriasis.

Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide.

Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics.

Method of Assessing Skin Cancerization and Keratoses (MASCK™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization.

Background: A range of 'field-directed' treatments is available for the management of extensive skin field cancerization (ESFC), but to date, the only validated objective quantitative tools are limited to assessment of actinic keratoses (AKs) affecting the head.

Aims: To develop a versatile quantitative instrument for objective clinical assessment of ESFC and perform initial internal validation across multiple anatomical zones.

Methods: The study comprised instrument development, pilot testing and instrument refinement and two rounds of reliability and inter-rater validation testing.

Atopic dermatitis in adults: An Australian management consensus.

Background/objectives: Atopic dermatitis (AD) has significant negative impact on health-related quality of life, mood, sleep, work productivity and everyday activities. Research into the use of new drugs in the management of AD continues to develop, and international updates and recommendations have been published. However, questions remain in the Australian setting.

In-Transit Metastasis From Squamous Cell Carcinoma.

Background: In-transit metastasis from cutaneous squamous cell carcinoma (SCC) is an uncommon form of metastasis through lymphatics and occurs more commonly in immunosuppressed patients.

Objective: To identify cases of in-transit SCC and determine patient characteristics, tumor features, management, and prognosis.

Methods And Materials: A multicenter case series treated by Australian and New Zealand clinicians.

The efficacy and safety of topical 5% 5-fluorouracil in renal transplant recipients for the treatment of actinic keratoses.

Actinic keratoses (AK) occur more commonly and behave more aggressively in renal transplant recipients (RTR). Topical 5% 5-fluorouracil (5-FU) cream is a commonly used agent whose efficacy and safety have never been exclusively studied in the RTR population before. Eight RTR were enrolled and 5% 5-FU cream applied to AK lesions on their face twice daily for 3 weeks.

Acroangiodermatitis in a lower leg amputee related to suction socket use.

Acroangiodermatitis is a rare condition with numerous causes typically presenting as purple macules on the lower extremities. Although benign, it can mimic the presentation of more serious underlying conditions such as Kaposi's sarcoma. We present a case of acroangiodermatitis in the stump of an amputee related to suction socket use in order to raise awareness of an unusual setting for this vascular proliferation.

'Great tan but I feel awful'. Diagnosis: Autoimmune primary hypoadrenalism.

'Everyone says I look great but I feel awful. I've lost weight, I feel sick all the time, I don't have any energy and I struggle just to get through the day'. Andrew is lean and tanned, but he has lost 8 kg since his last visit 3 months ago.

Is it insulin allergy?

'I'm allergic to that insulin you gave me. The injections sting and leave marks that last more than a week'. When Joe pulls up his shirt you can see the marks.

More than just dry skin.

Harriet is worried about her husband George. You don't see George very often but he certainly looks different. Apart from the changes described by Harriet, George has put on a lot of weight (from 97 to 112 kg since his last 'weigh in' 14 months ago).

Pigmented and thickened axillary folds.

Andrew, 45 years of age, presents with a 12 month history of dark, thickened skin in both axillae. He is concerned about the appearance and would like to know how to treat it. He is moderately obese, with a body mass index (BMI)of 31.

Skin and Cushing syndrome.

'I feel like a traffic light stuck on red. My friends ask me if I'm having hot flushes but this isn't flushes, it's permanent and I'm still having periods.' Carol is describing her facial appearance.

Endocrinology and the skin.

'I've got these ugly red blotches on my legs and they are getting worse?' Lisa, 32 years of age, is an accountant who always presents herself meticulously. You can understand why she doesn't like the raised red brown blotches on her shins. The lesions are raised, indurated with follicular accentuation.

Diabetes and the skin - onychomycosis.

Case history - Oliver: Oliver is aged 70 years, has had type 2 diabetes for 18 years, and has been treated with insulin for 4 years. He presents after two episodes of cellulitis of his right lower leg and forefoot, which have cleared on antibiotics. There are no residual skin changes on his leg and forefoot other than some postinflammatory pigmentation.

Acute skin irritant effects of cyanobacteria (blue-green algae) in healthy volunteers.

Objective: To assess the skin irritant potential of a range of laboratory grown cyanobacterial species using skin-patch testing on human volunteers.

Methods: Cell suspensions and extracts of cyanobacterial cultures of Microcystis aeruginosa (non-toxic strain), Anabaena circinalis and Nodularia spumigena were applied to 64 volunteers in one trial, and Microcystis aeruginosa (toxic strain), Apanocapsa incerta and Cylindrospermopsis raciborskii were applied to 50 volunteers in a second trial. Six cell concentrations of each organism in the range from less than 5000 to greater than 200,000 cells/mL were applied in random order using adhesive skin patches (Finn Chambers).

A prospective study of the use of cryosurgery for the treatment of actinic keratoses.

Background: Actinic keratoses are the most common actinic lesions on Caucasian skin. Cryosurgery with liquid nitrogen is commonly used to treat actinic keratoses, but there have been few studies examining the true rate of cure in everyday dermatologic practice.

Aim: To determine prospectively the true efficacy of cryosurgery as a treatment for actinic keratoses in everyday dermatologic practice.

Acitretin for chemoprevention of non-melanoma skin cancers in renal transplant recipients.

A prospective, open randomized crossover trial was conducted to evaluate the efficacy of acitretin for chemoprevention of squamous cell carcinomas and basal cell carcinomas in renal allograft recipients. Analysis was performed according to the intention-to treat principle. Twenty-three patients with previous history of non-melanoma skin cancer enrolled into the study and were randomly allocated into two groups.