Cigarette smoking and malignant melanoma: a case-control study.

BACKGROUND: Several previous studies have reported inverse associations between cigarette smoking and melanoma. Often these studies have not adjusted for ultraviolet (UV) exposure history, skin type, or number of blistering sunburns, which could confound the observed associations between cigarette smoking and melanoma. OBJECTIVE: We sought to assess whether this reported inverse association persists after adjusting for UV exposure, skin type, and number of blistering sunburns. METHODS: We conducted a population-based case-control study (82 patients with melanoma, 164 control subjects). Two control subjects were matched to each patient by age, sex, race, and skin type. Conditional logistic regression models were fit to assess the association between cigarette smoking history and melanoma, with additional adjustments for UV exposure and sunburns. RESULTS: Compared with never smoking, both former (odds ratio 0.43, 95% confidence interval 0.18-1.04) and current (odds ratio 0.65, 95% confidence interval 0.19-2.24) smoking were inversely associated with melanoma, but the associations were not statistically significant. LIMITATIONS: The number of cutaneous nevi was not assessed in this study. In addition, the relatively small number of patients limits the statistical precision of the observed associations. CONCLUSIONS: After matching for age, sex, race, and skin type, and further adjusting for UV exposure and number of sunburns, cigarette smoking was not statistically significantly associated with melanoma risk, but the results were consistent with previous observations of an inverse association.

Management of acute partial-thickness bums.

More than 1 million burns occur annually in the United States. The management of first-degree burns is limited to minor pain control whereas third-degree burns require skin grafting. However, second-degree/partial-thickness burns disrupt the epidermis and part of the dermis, thereby requiring acute wound care, pain control, and infection control. There are many different topical treatments and dressings for acute partial-thickness burns, and the clinical superiority of any one treatment is unclear. Because dermatologists may manage acute outpatient burns, we review the most widely utilized treatments that may be administered on an outpatient basis.

A review of epidermal maturation arrest: a unique entity or another description of persistent granulation tissue?

OBJECTIVE: To conduct a review of reported cases of epidermal maturation arrest and to compare their clinical and histological descriptions with that of persistent granulation tissue with a focus on diagnostic methods and response to treatment. METHODS: The authors performed a literature search within Pubmed, Embase, Google Scholar, and Web of Science for all reported cases of epidermal maturation arrest under the terms "epidermal maturation arrest," "epidermal arrest," "epidermal maturation," and "re-epithelialization maturation arrest." They reviewed the clinical and histological presentation of hypergranulation tissue as well as the evidence for the most widely used treatments. RESULTS: There is only one case series and one case report of epidermal maturation arrest, and the former gives the most detailed clinical and histological description including response to treatment. The clinical description, histological findings, and response to treatment of all cases are comparable to that of persistent granulation tissue and there is no histological or cytological data provided to support that epidermal maturation arrest exists as a distinct entity. CONCLUSION: Among the cases of epidermal maturation arrest reported in the literature, there is insufficient evidence that keratinocytes acquired a state of arrest in their migration. Rather, the described cases appear to have been complicated by persistent granulation tissue, a well-known aberration in wound healing.