Ida Orengo

Dog, cat, and human bites: A review

It is estimated that half of all Americans will be bitten by an animal or another human being during their lifetimes. The vast majority of the estimated 2 million annual mammalian bite wounds are minor, and the victims never seek medical attention. Nonetheless, bite wounds account for approximately 1% of all emergency department visits and more than

Cutaneous metastasis: A meta-analysis of data

30 million in annual health care costs. Infection is the most common bite-associated complication; the relative risk is determined by the species of the inflicting animal, bite location, host factors, and local wound care. Most infections caused by mammalian bites are polymicrobial, with mixed aerobic and anaerobic species. The clinical presentation and appropriate treatment of infected bite wounds vary according to the causative organisms. Human bite wounds have long had a bad reputation for severe infection and frequent complication. However, recent data demonstrate that human bites occurring anywhere other than the hand present no more of a risk for infection than any other type of mammalian bite. The increased incidence of serious infections and complications associated with human bites to the hand warrants their consideration and management in three different categories: occlusional/simple, clenched fist injuries, and occlusional bites to the hand. This article reviews dogs, cat, and human bite wounds, risk factors for complications, evaluation components, bacteriology, antimicrobial susceptibility patterns, and recommended treatments. Epidemiology, clinical presentation, and treatment of infections caused by Pasteurella multocida, Capnocytophaga canimorsus, Eikenella corrodens, and rhabdovirus (rabies only) receive particular emphasis.

Herpesvirus-like DNA sequences in non-Kaposi's sarcoma skin lesions of transplant patients

Background Previous studies of the incidence and the most common causes of cutaneous metastasis have not led to a consensus. We compiled data from many retrospective studies and from patient data registries and autopsies to increase the total number of cases available for a larger analysis of this subject. This study was conducted to gain a better understanding of the true incidence of cutaneous metastasis, the tumors most commonly involved in this presentation, and the locations of such lesions. Methods A meta-analysis of cutaneous metastases from patient tumor registries and autopsic studies was performed. Results The overall incidence of cutaneous metastasis is 5.3%. The most common tumor to metastasize to the skin is breast cancer. The chest is the most common site of cutaneous metastasis. Every practitioner should be highly suspicious of acute-onset, persistent, firm papulonodules, especially when they develop on the chest. Conclusion This meta-analysis greatly increases the total number of cases available for the analysis of cutaneous metastases and provides a better overall view of this topic than was previously possible.

INFLUENCE OF DIETARY MENHADEN OIL UPON CARCINOGENESIS AND VARIOUS CUTANEOUS REspONSES TO ULTRAVIOLET RADIATION

Herpesvirus-like DNA sequences (KSHV) have been reported to be associated with various forms of Kaposis sarcoma (KS). To determine if KSHV was associated with other proliferative skin lesions from non-AIDS immunocompromised patients, 33 skin lesions (basal cell carcinomas, squamous cell carcinomas, actinic keratoses, verruca vulgaris, atypical squamous proliferations, and seborrhoeic keratosis) from 4 organ-transplant patients receiving immunosuppressive therapy were tested for KSHV by PCR. KSHV sequences were detected in 82% of these skin lesions. Our results suggest that KSHV is associated with lesions other than KS in non-AIDS immunocompromised patients, and may also be involved in the pathogenesis of the various forms of proliferative skin lesions from organ-transplant patients.

Anti‐inflammatory activity of antifungal preparations

Abstract Recent reports suggest that eicosapentaenoic acid (EPA) inhibits growth of transplanted tumors and the formation of various chemically induced cancers in animals. Menhaden oil is a source of polyunsaturated lipid with a high content of EPA, an omega‐3 fatty acid. We sought to explore the effects of menhaden oil on photocarcinogenesis by employing the hairless mouse/UV‐carcinogenesis model. Five groups of 40 SKH‐Hr‐1 mice received (a) a semipurined equicaloric diet containing either 0.75% corn oil, 4% corn oil. 4% menhaden oil or 12% menhaden oil and (b) an escalating regimen of UV radiation to a cumulative dose of 70 J/cm2. Additional animals were employed to further examine the role of menhaden oil in acute cutaneous responses to UV, i.e., erythema, edema, and ornithine decarboxylase (ODC) induction. After a 2‐week feeding period UV‐induced ODC activity in mice receiving 12 or 20% menhaden oil was 3 to 13‐fold lower than that of corn oil fed animals. Further studies showed that edema was also markedly decreased. Animals receiving menhaden oil required twice the level of irradiance to evoke a comparable erythema as that which occurred in corn oil fed animals.

Correlation of histologic subtypes of primary basal cell carcinoma and number of Mohs stages required to achieve a tumor-free plane

Background Although steroid/antifungal combination medications are used extensively, they are associated with potential disadvantages. Antifungal preparations possessing inherent anti‐inflammatory activity, leading to rapid symptomatic relief while providing mycologic cure, would be very useful.

The Q‐switched ND: YAG Laser Effectively Treats Tattoos in Darkly Pigmented Skin

BACKGROUND Certain histologic subtypes of basal cell carcinoma (BCC) behave more aggressively and require more aggressive treatment. OBJECTIVE The aim of this study was to see whether certain subtypes of BCC require more Mohs stages to achieve tumor-free margins. METHODS A retrospective study of 342 primary BCCs treated with Mohs micrographic surgery (MMS) was performed identifying the histologic subtype of BCC present and the number of stages required to clear the tumor. RESULTS The aggressive subtypes (infiltrative, morpheaform, micronodular, and mixed) were most frequently found when high numbers of Mohs stages were required for cure. CONCLUSION The more aggressive subtypes of BCC require more MMS stages to achieve tumor-free margins, which is consistent with the concept that these subtypes usually require more aggressive treatment from the start.

Influence of fish oil supplementation on the minimal erythema dose in humans

background Laser therapy for removal of cosmetic tattoos has been proven efficacious in lighter skin. Few studies have been reported using the Q‐switched neodymium‐yttrium‐aluminum‐garnet (Nd:YAG) laser to treat tattoos in darkly pigmented or type VU skin, however. objective To report results using the Q‐switched Nd:YAG laser to remove tattoos from type VI skin. methods Eight darkly pigmented patients had 15 amateur tattoos treated with the Q‐switched Nd:YAG laser. Treatments numbered three or four on average and were given at 8‐week intervals. Results were rated by the patients and by a panel of four physicians. results Eight of 15 tattoos were rated as 75–95% cleared after therapy. Another five tattoos were 50% cleared. Two tattoos were only 25% cleared, but underwent only two treatments. None of the patients reported any changes in texture of their skin post therapy. Thirteen of 15 tattoos were removed without any change in the color of the involved skin. The other two tattoos were removed with only slight lightening of the skin. conclusion When treating patients in whom there is a significant risk for keloid scarring or destruction of natural pigment as a consequence of tattoo removal, the Q‐switched Nd:YAG laser appears to be an excellent choice of therapy.

The effect of dietary fish oil supplementation on psoriasis: Improvement in a patient with pustular psoriasis

SummaryA previous study using the hairless mouse model demonstrated that diets containing a fish-oil lipid source, which contained high levels of omega-3 fatty acids, markedly increased the minimum erythema dose (MED) when compared with diets containing other polyunsaturated fatty acids. To determine whether fish oil supplementation could produce a similar effect in humans, 20 subjects were randomized into two groups, a placebo group and a group receiving fish-oil supplements over a 4-week period. Results showed a small, but statistically significant, increase in MED in patients whose diet was supplemented with fish oil. Cholesterol and prostaglandin E2 levels were unchanged, while triglyceride levels were significantly decreased in the fish oil group. No significant changes in any of these parameters occurred in the placebo group.

Histologic patterns of basal cell carcinoma based upon patient immunostatus.

An open study testing the effects of fish oil supplementation on psoriasis in 26 patients is described. None of the patients with plaque-type psoriasis vulgaris showed clinically significant improvement; however, a patient with generalized pustular psoriasis showed marked improvement with the fish oil supplementation. In this patient, scale leukotriene B4 levels were determined and shown to be significantly decreased after completion of the study, but the leukotriene B4 levels did not correlate with her clinical course. The results of our study are contrasted with those of a recent study that did show beneficial effects of fish oil supplementation on plaque-type psoriasis.