M. Rashid

Chemotherapy-induced alopecia.

Chemotherapy-induced alopecia is a distressing side effect common to certain treatment regimens in oncology. Unfortunately, chemotherapy-induced alopecia is an often overlooked or minor factor among our current research priorities and thus advances in amelioration have been minimal. This review offers a comprehensive examination of the clinically relevant basic science, clinical research, and current management options for chemotherapy-induced alopecia. We emphasize that hair loss secondary to chemotherapy is not as random or nonspecific in patterns or extent of disease, as one would initially perceive. Patient support and education information and templates are provided to facilitate patient treatment.

Silver sulfadiazine for the treatment of partial-thickness burns and venous stasis ulcers

BACKGROUND For decades silver-containing antibiotics such as silver sulfadiazine (SSD) have been applied as standard topical therapy for patients with partial-thickness burns and venous stasis ulcers. This evidence-based review intends to answer the following research question: in ambulatory patients with partial-thickness burns or stasis dermatitis ulcers, does the use of topical SSD compared with nonantibiotic dressings improve mortality, wound healing, re-epithelialization, or infection rates? METHODS MEDLINE, EMBASE, Cochrane Library, and other databases were searched. We considered trials that enrolled patients of any age with partial-thickness burns or venous stasis ulcers and randomized them to either topical SSD or placebo, saline-soaked gauze, paraffin gauze, sterile dry dressing, or nonantibiotic moist dressing. Outcomes included mortality, wound healing, speed of re-epithelialization, and infection rates. RESULTS For burns, our search revealed 400 potential articles. No human studies met the inclusion criteria. Only 7 animal studies (1 mouse, 4 rat, and 2 pig) were relevant to the proposed question. These animal studies provided conflicting results. Whereas some support the use of SSD for treatment of partial-thickness burns, others question its effectiveness. For stasis dermatitis ulcer, the search identified 50 articles for review, of which 20 abstracts were reviewed, and one article met the inclusion criteria. This study did not show any significant improvement in the rate of complete healing in SSD group compared with placebo either at 4 weeks (relative risk 6.2, 95% confidence interval 0.8-48) or at 1 year (relative risk 5.2, 95% confidence interval 0.6-41.6) of follow-up. CONCLUSION There is insufficient evidence to either support or refute the routine use of SSD for ambulatory patients with either partial-thickness burns or stasis dermatitis ulcers to decrease mortality, prevent infection, or augment wound healing in human beings.

Onychoheterotopia: Pathogenesis, presentation, and management of ectopic nail

BACKGROUND Onychoheterotopia is an extremely rare condition in which the nail tissue grows outside the classic nail unit of the dorsal fingers and toes. It presents as either small outgrowths of a deviant nail or a complete double fingernail malformation. The histology of the onychoheterotopia matrix is oftentimes very similar to the normal nail matrix, although it plays a central role in diagnosis. OBJECTIVE We sought to review the current literature on the clinical and histologic aspects of onychoheterotopia. METHODS A literature search was performed to evaluate peer-reviewed articles on the topic. RESULTS Detailed reports have characterized many features of onychoheterotopia. The various etiology and treatment options are reviewed. LIMITATIONS The study was limited to those articles in the English-language literature. CONCLUSIONS In this article, we provide a review of the literature based on the current understanding of onychoheterotopia, its diagnosis, and its management.

Chronic rhinosinusitis and psoriasis: do mutually exclusive systemic Th1 and Th2 disease patterns exist?

Conclusion: Our results support the theory that chronic rhinosinusitis (CRS) is a systemic Th alteration, the relevance of which is discussed in detail. Objective: CRS imposes a heavy burden on society; however, a reliable CRS therapy has not been found. Developing a better understanding of this pathology will help us in our search for more effective therapies. One question, which is rarely examined, is the possibility of CRS existing as a systemic immune alteration in Th response. Thus, the goal of this study was to examine the occurrence of CRS, a Th2 pathology, with Th1 pathologies such as psoriasis. Patients and methods: This study was performed via a retrospective electronic query of our medical center in regards to patients coded with the respective diagnosis. Results: Analysis of the data showed that occurrence of CRS rarely coincided with the occurrence of psoriasis and other such Th1 pathologies.

Averting the proliferation of acronymophilia in dermatology: Effectively avoiding ADCOMSUBORDCOMPHIBSPAC

D iseases and syndromes in medicine are often described by descriptive phrases, eponyms, or acronyms. In addition, mnemonic devices—primarily acronyms—have been extended beyond disease processes and applied liberally in clinical trials, screening instruments, and even magnetic resonance imaging (MRI) pulse sequences. It is not uncommon for a single disease process to be known by three different names or for a single acronym to be applied to scores of uses in medical nomenclature. The proliferation of acronym usage in medicine has been heavily discussed over the past few decades. 5,12-19 However, this topic has not been addressed in the dermatology literature. As the field of dermatology begins to see its own impending proliferation of acronymophilia, it is important to assess the utility of such naming practices, especially (1) given the visual/descriptive nature of the field and (2) as multiple new acronyms are proposed every year. For example, Kreuter et al recently labeled a human papillomaviruseassociated disease as WILD (warts, immunodeficiency, lymphedema, and dysplasia) syndrome, an acronym based on the physical and immunologic aspects of the disease. Before the utility of mnemonic devices can be discussed, the basis of memory should quickly be reviewed. In 1985, Sarter and Markowitsch reviewed the amygdala’s role in memory processing based on human case reports and lesion studies in animals. Later, Barbas reviewed the neuroanatomic

Medical eponyms: our past, present, and future

Medical eponyms: our past, present, and future Eponyms play a historic role in medicine. The purpose of this letter is to enlighten and encourage those of us who thought eponym creation in the medical field has long been abandoned. A quick search on eponyms reveals that the literature continues to be flooded with lively and colorful debates. These debates are for and against this ancient naming practice. 1–3

Hyaluronic acid filler for steroid atrophy.

The use of hyaluronic acid for atrophy has not been documented in the literature. In this manuscript we present a case of a patient treated with the aforementioned filler with enthusiastic results. This case shows yet another potential application for these novel products.

Hair in the middle phalanges: clinical significance

Middle phalangeal hair has been a focus of study in different populations for the absence or presence of this trait. Clinically, this is often perceived as a solely cosmetic feature. However, because of a series of patients questioning the presence of hair on this location, we have performed a more in‐depth literature‐based evaluation of the trait. The goal of this manuscript was to examine the clinical significance of this anthropological phenomenon. A literature review was performed that focused on the differences of this trait in terms of pattern of presentation, age, race, sex, and usage as an identifiable marker for medical significance in certain medications and criteria for tailored treatment. Anatomically, middle phalangeal hair is mostly on the fourth finger and more ulnar rather than central or symmetric in pattern of deviation. Its presence has been most associated with high prenatal androgen exposure, predisposing patients to suffer from adverse side effects from oral contraceptives. Phalangeal hair may be helpful in tailoring treatment to certain patients from different ethnic backgrounds, and particularly in individuals with unknown ancestry.

Problems in pattern alopecia

Female pattern hair loss (FPHL) was originally described as synonymous with androgenetic alopecia. However, the role of androgens in FPHL has not been proven, and the etiology is not yet defined. Several patterns of hair loss in women have been described, in addition to descriptions of scarring alopecias mimicking FPHL. In this paper, we discuss FPHL as an entity other than androgenetic alopecia and suggest that de‐emphasizing the physicians reliance on pattern in the diagnosis of hair loss in women, and instead utilizing other tools including dermoscopy and histopathology, would benefit clinician’s efforts in treating alopecias.

Twenty-four-month persistence of hyaluronic acid filler for an atrophic scar

A 24‐month follow up of a previously reported case of successful hyaluronic acid filler use in steroid atrophy is presented. The patient had persistence of the volume and appearance of her scar with sustained satisfaction 24 months after hyaluronic acid treatment, without the need for repeat injection. This case suggests expansion of the use of hyaluronic acid fillers to include scar atrophy, as persistence of a desired cosmetic appearance for 2 years is demonstrated.