RESUMEN
BACKGROUND: The management of skin cancers has evolved with the development of Mohs micrographic surgery and a greater emphasis on surgical training within dermatology. It is unclear whether these changes have translated into innovations and contributions to the reconstructive literature. OBJECTIVE: To assess contributions from each medical specialty to the cutaneous head and neck oncologic reconstructive literature. METHODS: The authors conducted a systematic review of the head and neck reconstructive literature from 2000 through 2015 based on a priori search terms relating to suture technique, linear closure, advancement, rotation, transposition and interpolation flaps, and identified the specialty of the senior authors. RESULTS: The authors identified 74,871 articles, of which 1,319 were relevant. Under suture technique articles, the senior authors were primarily dermatologists (58.2%) and plastic surgeons (20.3%). Under linear closure, the authors were dermatologists (48.1%), plastic surgeons (22.2%), and otolaryngologists (20.4%). Under advancement and rotation flaps, the senior authors were plastic surgeons (40.5%, 38.9%), dermatologists (38.1%, 34.2%), and otolaryngologists (14.4%, 21.6%). Under transposition and interpolation flaps, the senior authors were plastic surgeons (47.3%, 39.4%), dermatologists (32.3%, 27.0%), and otolaryngologists (15.3%, 23.4%). CONCLUSION: The primary specialties contributing to the cutaneous head and neck reconstructive literature are plastic surgery, dermatology, and otolaryngology.
Asunto(s)
Cirugía de Mohs/normas , Procedimientos de Cirugía Plástica/normas , Neoplasias Cutáneas/cirugía , Colgajos Quirúrgicos/normas , Competencia Clínica , Dermatología/normas , Dermatología/estadística & datos numéricos , Humanos , Cirugía de Mohs/métodos , Cirugía de Mohs/estadística & datos numéricos , Otolaringología/normas , Otolaringología/estadística & datos numéricos , Procedimientos de Cirugía Plástica/métodos , Procedimientos de Cirugía Plástica/estadística & datos numéricos , Cirugía Plástica/normas , Cirugía Plástica/estadística & datos numéricos , Colgajos Quirúrgicos/estadística & datos numéricos , Técnicas de Sutura/normas , Técnicas de Sutura/estadística & datos numéricos , Estados Unidos/epidemiología , Técnicas de Cierre de Heridas/normas , Técnicas de Cierre de Heridas/estadística & datos numéricosRESUMEN
BACKGROUND: Isotretinoin is an effective treatment for nodulocystic acne. Outside of required pregnancy testing, laboratory monitoring suggested by the manufacturers is vague. Dermatologists, therefore, monitor a variety of tests with variable frequency. Despite intense monitoring, the majority of patients do not have gross laboratory abnormalities that warrant changes in management.
OBJECTIVE: To survey US dermatologists regarding laboratory monitoring practices while prescribing isotretinoin.
METHODS: An online survey sent via e-mail to members of the American Academy of Dermatology.
RESULTS: 12,396 surveys were sent with a response rate of ~19%. At baseline >60% of responders check a CBC, LFTs, and a lipid panel. 74% check a monthly lipid panel and LFTs, while 57% check a monthly CBC. 75% report stopping isotretinoin when AST or ALT values reach 3 times normal; 89% report stopping at 4 times normal. When triglycerides reach 4 times normal, 72% stop the medication.
CONCLUSIONS: There is no consensus on isotretinoin monitoring tests and frequency, though the majority of dermatologists surveyed monitor a lipid panel and LFTs.
J Drugs Dermatol. 2017;16(6):557-564.
.Asunto(s)
Fármacos Dermatológicos/uso terapéutico , Dermatólogos , Isotretinoína/uso terapéutico , Acné Vulgar/tratamiento farmacológico , Adulto , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Femenino , Encuestas de Atención de la Salud , Humanos , Isotretinoína/administración & dosificación , Isotretinoína/efectos adversos , Lípidos/sangre , Monitoreo Fisiológico , Pautas de la Práctica en Medicina , Embarazo , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Zoon's balanitis, is typically found in older, uncircumcised males and can be asymptomatic, pruritic, or cause dysuria. The typical appearance is erythematous, discrete, moist plaques with a "cayenne pepper" speckled appearance and an orange hue on the glans penis and sometimes prepuce, which may display "kissing lesions" on areas that are in direct contact with the lesions.These may eventually erode and leave a "rusty stain". Histologically, these have a dense lichenoid infiltrate in the upper and mid dermis with abundant plasma cells.