Telangiectasia macularis eruptiva persians presenting as island sparing.

Mastocytosis is characterized by the proliferation and accumulation of mast cells within organs and most commonly the skin; localization accounting for the frequent presentation of skin lesions in affected individuals. The authors detail a case report involving a patient with telangiectasia macularis eruptive perstans, a rare cutaneous form of mastocytosis, accompanied by an unusual clinical finding of island sparing.

Granuloma annulare treated with excimer laser.

OBJECTIVE: To review the current therapy for granuloma annulare and report a case of refractory generalized granuloma annulare successfully treated with excimer laser. A discussion about the characteristics of excimer laser and the mechanism of its effectiveness is presented. DESIGN: Patient case report and literature review. SETTING: Outpatient dermatology practice. PARTICIPANTS: A 73-year-old woman suffering from generalized granuloma annulare for more than 40 years. MEASUREMENTS: Change in clinical appearance of lesions. RESULTS: Use of excimer laser therapy resulted in prompt and complete resolution in treated areas with no residual skin changes or side effects. CONCLUSION: Excimer laser therapy is a powerful treatment modality with minimal side effects for patients with granuloma annulare. Further study is necessary to elucidate optimal dosing, long-term efficacy, and safety profile.

Oregano extract ointment for wound healing: a randomized, double-blind, petrolatum-controlled study evaluating efficacy.

BACKGROUND: Wound healing is a dynamic and complex process affected by tissue hydration, the presence of bacteria, inflammation, and other variables. Oregano has potent antibacterial, antifungal, antioxidant, and anti-inflammatory properties. Studies of oregano ointment on wound healing are lacking. OBJECTIVE: To determine the efficacy of 3% oregano extract ointment on wound healing. METHODS: An investigator initiated, randomized, double-blind, petrolatum-controlled study was performed to determine the effects of oregano ointment on wound healing. Forty patients who underwent surgical excision were enrolled and randomized. Cultures were obtained on day 12 and scars were evaluated using the Patient and Observer Scar Assessment tool on day 12, 45, and 90. RESULTS: The oregano ointment group had 19 percent of cultures test positive for Staphlococcus aureus compared to 41 percent in the petrolatum group. One patient in the oregano ointment group developed a cellulitis compared to three patients in the petrolatum group. The oregano group had a statistically significant improvement over petrolatum in scar color, pigmentation, and pliability. CONCLUSION: Oregano extract ointment decreased bacterial contamination and subsequent infection on post-surgical wounds and had equivalent overall scar appearance compared to petrolatum.

Nonmelanoma skin cancer of the ear: frequency, patients' knowledge, and photoprotection practices.

BACKGROUND: Nonmelanoma skin cancer (NMSC) is the most common cancer in the world. Information about NMSC on the ear and photoprotection practices of the ear is limited. OBJECTIVE: To determine the frequency of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) at precise anatomical sites, with a special focus on the ear. To evaluate dermatology patients' knowledge about skin cancer, photoprotection practices, and use of photoprotection on the ear. METHODS: At a dermatology practice in Fresno, California, a retrospective chart review of 643 patients diagnosed with NMSC was performed and categorized into detailed anatomical sites. An anonymous questionnaire was given to patients aged 18 and older seen at this private practice. RESULTS: One thousand three hundred eleven NMSCs were biopsied and histologically confirmed. Of these, 538 were BCC (41%) and 773 (59%) were SCC. Seven hundred sixty-five tumors (58.4%) were on the head. The ear was the fifth most common site for NMSC on the head. The male:female ratio for NMSC of the ear was 17:1. There were 269 survey responses; 72.8% used sunscreen, but only 26.0% of those who used sunscreen always apply it to their ears. CONCLUSION: Directed public education about the ear as a high-risk, common site for NMSC is needed. The authors have indicated no significant interest with commercial supporters.

New strategies in nonoperative management of meconium ileus.

PURPOSE: The aim of this study was to develop new nonoperative strategies for the management of meconium ileus in an attempt to improve on the current unacceptable failure rate. METHODS: Mice were constipated with subcutaneous morphine injection. Each then received an enema solution (perflubron, surfactant, Tween-80, Gastrografin, Golytely, DNase, N-Acetylcysteine, Viokase, or normal saline). After the enema solution was administered, stool output was quantitated. Histologic examination of the intestines was performed on a second group of mice that also received enemas. Finally, viscosity measurements were taken of human meconium at baseline and after variable incubation periods with each test solution. RESULTS: For relieving constipation in vivo, Gastrografin enema was most efficacious. All agents were equally benign to the intestinal mucosa. In vitro, only 4% N-Acetylcysteine and perflubron were less effective at decreasing meconium viscosity than normal saline at T = 0 hours, with N-Acetylcysteine producing greater reduction in viscosity than normal saline at T = 6 hours. CONCLUSIONS: Our results show that surfactant and Gastrografin are the most effective for the in vivo relief of constipation. This is accomplished without mucosal damage. These agents also significantly reduce viscosity in vitro, and we speculate that they may be beneficial in relieving constipation caused by meconium ileus in cystic fibrosis patients.