Nevus depigmentosus: review of a mark of distinction.

Nevus depigmentosus (ND), also known as nevus achromicus or achromic nevus, is an uncommon congenital hypomelanosis of the skin that is often characterized as being nonprogressive and having serrated borders. It needs to be distinguished from other hypopigmented skin conditions such as nevus anemicus, hypomelanosis of Ito, Fitzpatrick patches (ash leaf spots) of tuberous sclerosis, vitiligo, indeterminate leprosy, and pigment demarcation lines. Treatment may be desired for aesthetic and possible psychosocial considerations. We review and update knowledge about ND and its simulants.

Impact of Cosmetic Camouflage on the Quality of Life of Children With Skin Disease and Their Families.

BACKGROUND/OBJECTIVES: Cosmetic camouflage is known to improve quality of life in adults. Few data are available regarding cosmetic camouflage in children, and thus it is not often selected as a mode of treatment. We sought to determine whether cosmetic camouflage leads to improved quality of life of pediatric patients with visible dermatoses and their parent or primary caregiver. METHODS: Patients aged 5 to 17 years with visible skin disease and their parent were assessed with the Children's Dermatology Life Quality Index (CDLQI) and the Family Dermatology Life Quality Index (FDLQI) before and after consultation regarding cosmetic camouflage. RESULTS: Twenty-two children with skin conditions were included in the study. The mean CDLQI decreased from 6.82 (SD = 1.28) to 3.05 (SD = 0.65; P = .0014), while the mean FDLQI decreased from 7.68 (SD = 1.15) to 4.68 (SD = 0.92; P = .0012). CONCLUSIONS: Our study highlighted improvement in quality of life in patients with skin disorders who were managed with cosmetic camouflage.

Awareness of sunburn in childhood, use of sunbeds and change of moles in Denmark, Northern Ireland, Norway and Sweden.

BACKGROUND: Malignant melanoma (MM) is increasing rapidly in Northern Europe. To reduce incidence and mortality through earlier diagnosis, public awareness of MM is important. Thus, we aim to examine awareness of risk factors and a symptom of MM, and how awareness varies by country and socio-demographic factors in Denmark, Northern Ireland (NI), Norway and Sweden. METHODS: Population-based telephone interviews using the 'Awareness and Beliefs about Cancer' measure were conducted in 2011 among 8355 adults ≥50 years as part of the International Cancer Benchmarking Partnership Module 2. Prevalence ratios (PRs) with 95% confidence intervals were calculated. RESULTS: In these four countries, lowest awareness was found for 'sunburn in childhood' (63%), whereas awareness was high for 'use of sunbeds' (91%) and 'mole change' (97%). Lack of awareness of 'sunburn in childhood' was more prevalent among respondents from Norway [PR = 1.38 (1.28-1.48)] but less prevalent among respondents from Northern Ireland (NI) [PR = 0.78 (0.72-0.85)] and Sweden [PR = 0.86 (0.79-0.93)] compared with respondents from Denmark. Lack of awareness of 'use of sunbeds' was more prevalent among respondents from Norway [PR = 2.99 (2.39-3.74)], Sweden [PR = 1.57 (1.22-2.00)], and NI [PR = 1.65 (1.30-2.10)] compared with respondents form Denmark. Being a man, age ≥70, living alone, and having lower education, were each independently associated with lack of MM-awareness. CONCLUSIONS: The results indicate relatively low awareness of 'sunburn in childhood' as a risk factor for MM, and important disparities in MM-awareness across countries and socio-demographic groups. Improved and more directed initiatives to enhance public MM-awareness, particularly about 'sunburn in childhood', are needed.

Laser therapy of a dermal nevus in the esthetic zone of the nasal tip: A case report and comprehensive literature review.

This case report demonstrates the ablation of a dermal nevus using a diode laser in the esthetically very demanding facial area of the nasal tip. The clinical outcome shows good results and a high level of patient satisfaction. Due to effective wound granulation and healing, elaborate skin grafts could be avoided. The application of the contact laser ensures safe treatment in highly perfused areas thanks to haptic feedback and good coagulative effect. The method should therefore be considered as an alternative to other ablative procedures for benign lesions in the facial area.

Analysis of psychopathological traits in psoriatic patients.

Psoriasis vulgaris is a multifactorial, heterogeneous disease that is associated with problems in skin image and feelings of shame and stigmatization. The aim of this study was to analyze psychopathological traits in patients with psoriasis and a comparative group. A total of 254 dermatological patients participated in the study: 124 patients with confirmed diagnoses of psoriasis vulgaris and 130 patients with melanocytic and non-melanocytic nevi on covered parts of the body. Psychometrically mensural and standardized instruments were used in the study: list of general data, appendix of disease data, Beck Depression Inventory test, State-Trait Anxiety Inventory, Measure of psychological stress and Eysenck's Personal Questionnaire. There is a significant statistical difference in the result of psychometric tests between the study groups. Patients with psoriasis have more severe symptoms of depression, more physical symptoms of anxiety and higher results on the anxiety scale as a state and as a trait p=0.000. Eysenck's personal questionnaire showed higher results on the psychoticism scale p=0.000 and lower results on the extraversion scale p=0.035 among psoriatic patients.

Categorization of Skindex-29 scores using mixture analysis.

BACKGROUND: Although the Skindex-29 is among the most commonly used health-related quality of life instruments in dermatology, the interpretation of obtained scores is not well documented. OBJECTIVE: To create categories of the scores of the Skindex-29. METHODS: The Skindex-29 scores of454 Italian patients with 6 distinct skin diseases from a specialized center were analyzed using mixture analyses. The validity of the obtained categorizations was tested. RESULTS: Mixture analysis showed 4 distinct components (categories) for the emotion and functioning scale and 5 for the symptom scale. The total Skindex-29 score was categorized into 4 levels. As expected, patients with inflammatory diseases had higher levels of impairment, those with vitiligo and alopecia areata had low symptom levels and those with nevi were predominantly located in the lower categories for each of the scales. CONCLUSION: The proposed categories of the Skindex-29 may ease the interpretation of obtained continuous scores.

[Surgical treatment for giant congenital nevi: what are the psychosocial consequences for the child and family?]. / Prise en charge chirurgicale des naevi géants congénitaux : quel retentissement psychosocial sur l'enfant et son entourage ?

Giant congenital nevus is a rare pathology. The incidence of malignant transformation exists and his unsightly aspect requires a early surgical treatment. All techniques of plastic surgery must have to be used. The management of the skin capital is a real surgical challenge with complications which are difficult to bear psychologically and physically for these young children. Authors present psychosocial effects of this pathology then surgical practice through 105 cases analysed. The majority of the patients had axial disposition of the nevus (head and trunk) and tissue expansion was the most utilised technique. A questionnaire estimated the notion of other's looking, congenital deformity's acceptance, surgical story's transmission, family's opinion of the surgical treatment. More than the half of families feel that their child was cast-off because of deformity. A lot of family would forget the nevus and never photographed their child with nevus. Sometimes, children could not explain their scars. Despite many hospitalisations, all the children have normal schooling and extra-school activities. It's important to begin surgical plan very early so that child could integrate their scars in their corporal schema.

The stigma of port-wine stains.

Patients with port-wine stains are now able to receive treatment to improve significantly their birthmark. Questionnaire studies of these patients have revealed considerable psychological distress. This article reviews the nature of that distress and the stigmatization suffered by patients with disfiguring birthmarks.

The sense of defect.

The sense of defect, physical or psychological, is here regarded as a fantasy, a compromise formation, rather than an actual defect existing somewhere in the body, or in some psychological structure. It need not correlate with the reality to an external observer of physical or psychological disability. Psychoanalytic emphasis is directed to the motivations for the persistence of this sense of defect, rather than primarily to etiology (trauma) or genetic history. Accurate perception and evaluation, having been interdicted during childhood, is avoided with the magical hope that thereby one will be acceptable and what is wrong will disappear. The interaction between self and parents, real and fantasied, cannot be clearly known. The patient remains uncertain as to what is wrong, in whom it is located, and how it has come about. The sense of defect, physical or psychological, becomes the nidus around which much is crystallized. This is then offered up to a parent (and the superego) as an appeasement and seduction, aiming to help this parent feel better by agreeing that the child is indeed the cause of what is wrong. Dangerously destructive (and sexual) wishes are defended against and atoned for by emphasis on one's defectiveness.

Minor aesthetic blemishes: the patient's unasked request.

This paper describes a case representative of a group of people who are troubled by cosmetic blemishes but are unable to verbalize their feelings. After appropriate treatment, they are able to verbalize their feelings and they feel great relief.

[Strategies used by patients with lateral telangiectatic naevi to handle their problems]. / "Bewältigungsstrategien" bei Patienten mit lateralen teleangiektatischen Naevi.

Considering the suitableness of operative therapies for remarkable skin defects without progrediency or malignity, we studied patients' feelings, cognitions and ways of acting with a special questionnaire. The forms were filled in by 28 patients with lateral telangiectatic naevi and a control group of 60 persons with normally constituted skin. The results did not show significant differences between the two groups. Therefore, the indications for surgery or radiotherapy have to be set up very cautiously.