Mandy Harting

Self-Healing Collodion Membrane and Mild Nonbullous Congenital Ichthyosiform Erythroderma Due to 2 Novel Mutations in the ALOX12B Gene

BACKGROUND Collodion phenotype is a term applied to the condition affecting a newborn involving a parchmentlike membrane covering the whole body surface (collodion membrane). This presentation is common to several different forms of autosomal recessive congenital ichthyoses, including nonbullous congenital ichthyosiform erythroderma (NCIE), lamellar ichthyosis (LI), and harlequin ichthyosis (HI). Recent years have seen considerable advances in our understanding of the molecular basis of autosomal recessive forms of congenital ichthyosis. Several genetic loci have been identified for LI and NCIE. OBSERVATIONS We describe the clinical and molecular features of 2 cases of self-healing newborns of collodion phenotype developing mild NCIE. A dramatic improvement of the skin was observed in the first few weeks after birth in both cases. The molecular analysis of the ALOX12B gene demonstrated that both patients were compound heterozygous for previously unreported mutations. CONCLUSIONS Both patients were compound heterozygous for novel ALOX12B mutations, underscoring the concept that mutations in at least 2 different genes, ALOX12B and TGM1, may result in this unusual clinical phenotype.

Antibiotic Use in Sexually Transmissible Diseases

Sexually transmissible diseases (STDs) remain a major health issue worldwide, with approximately 300 million new cases annually. STDs caused by bacteria can be treated with antibiotics, although the susceptibility pattern of many etiologic microbes has changed over the past few decades. Syphilis remains best managed with single-dose benzathine penicillin G. Other single-dose antibiotic regimens for lues are either associated with clinical failure or of uncertain dosage. However, single-dose azithromycin and ceftriaxone are suitable for chancroid. Lymphogranuloma venereum, reemergent as a cause of proctitis, is treated with prolonged courses of doxycycline or minocycline. Trimethoprim-sulfamethoxazole has replaced tetracycline derivatives as preferred treatment for donovanosis in many regions. Parenteral cephalosporins, such as ceftriaxone, cefotaxime, and ceftizoxime, are initial interventions for disseminated gonococcemia. Pending culture results, genital bite wounds (often consisting of deep, painful ulcerations) should be treated with high-dose amoxicillin-clavulanic acid.

Systemic and barrier contraceptives for the dermatologist: a review

This review focuses on the contraceptive knowledge of dermatologists in the United States of America. It explains that dermatologists administer systematic agents such as thalidomide isotretinoin and acetretin methotrexate and other immunosuppressives tetracycline derivatives and antifungal agents which have mild moderate or severe teratogenic potential and that it is imperative for dermatologists to know what contraceptive options are available for patients.

Invasive Squamous Cell Carcinoma of the Skin

Squamous cell carcinoma (SCC) of the skin is an invasive, malignant neoplasm arising from the keratinizing cells of the suprabasilar epidermis or epidermal appendages. SCC and basal cell carcinoma (BCC) comprise the majority of nonmelanoma skin cancers (NMSCs), and together they account for the most common malignancy worldwide. SCC represents a histo-logical and clinical evolutionary spectrum of disease, ranging from preinvasive cases of actinic keratosis and Bowens disease (SCC in situ) to frankly invasive SCC. As the subject of preinvasive SCC is covered in the preceding portion of this text, the present section focuses on the clinical features, diagnosis, and management of the various forms of invasive cutaneous SCC. Excision remains the treatment of choice, although radiotherapy, intralesional, or topical chemotherapy, and topical immunomodulatory therapy may prove effective in selective cases.

Letter: The Use of Sterile Gauze as a Retractor When Performing Surgery in the Web Spaces

Biopsies or excisions in the web spaces of the hands or feet are generally thought to be cumbersome due to difficulty in visualization. As a result of limited visual access, these procedures are often performed with an assistant providing retraction. However, the assistant’s hands repeatedly present an obstruction between the surgeon and the surgical site, given the small size of the lesions in consideration. Because excising lesions in the web spaces is usually thought of as an inconvenient or awkward procedure, these lesions are often referred to specialist such as Mohs surgeons and plastic surgeons.