Studying in dermatology residency.

Studying during dermatology residency may be overwhelming due to the large amount of material and numerous resources available. This article provides an overview of available resources and a guide on tailoring one's approach to studying throughout residency.

Over-the-counter topical products in dermatology.

Dermatologists must be familiar with the safety, utility, and tolerability of a range of over-the-counter (OTC) products. In this article, the role of the US Food and Drug Administration in regulating safety of OTC products is discussed. Additionally, resources to help guide clinicians to learn about the pharmacology and tolerability of OTC products are reviewed.

Handoffs in dermatology residency.

Dermatologists are required to keep track of a high volume of items after each patient encounter, including biopsies, laboratory tests, cultures, and imaging. In residency, there is a complicating factor of transitioning care to different providers. Residents currently utilize a variety of handoff and organizational practices. Residency provides an opportunity to become familiar with different handoff and organizational practices to take forward in one's career.

Diet and skin: a primer.

There are strong data on the relationship between dietary patterns and skin conditions. This article provides an introduction for dermatologists on the role of diet in 3 common skin conditions: acne vulgaris, psoriasis, and atopic dermatitis (AD). High glycemic index foods are associated with acne vulgaris. Psoriasis is associated with obesity and weight loss, and improved dietary patterns may improve cutaneous disease. Children with AD are at higher risk for food allergies, and a small subset may experience flares in relationship to non-IgE-mediated food allergies, though there is a need for further research to clarify which patient subsets require allergen testing and food avoidance.

Camphor white oil induces tumor regression through cytotoxic T cell-dependent mechanisms.

Bioactive derivatives from the camphor laurel tree, Cinnamomum camphora, are posited to exhibit chemopreventive properties but the efficacy and mechanism of these natural products are not fully understood. We tested an essential-oil derivative, camphor white oil (CWO), for anti-tumor activity in a mouse model of keratinocyte-derived skin cancer. Daily topical treatment with CWO induced dramatic regression of pre-malignant skin tumors and a two-fold reduction in cutaneous squamous cell carcinomas. We next investigated underlying cellular and molecular mechanisms. In cultured keratinocytes, CWO stimulated calcium signaling, resulting in calcineurin-dependent activation of nuclear factor of activated T cells (NFAT). In vivo, CWO induced transcriptional changes in immune-related genes identified by RNA-sequencing, resulting in cytotoxic T cell-dependent tumor regression. Finally, we identified chemical constituents of CWO that recapitulated effects of the admixture. Together, these studies identify T cell-mediated tumor regression as a mechanism through which a plant-derived essential oil diminishes established tumor burden.

Diseases of the lips.

Heath care providers should be comfortable with normal as well as pathologic findings in the lips, because the lips are highly visible and may display clinical manifestations of local, as well as systemic inflammatory, allergic, irritant, and neoplastic alterations. Fortunately, the lips are easily accessible. The evaluation should include a careful history and physical examination, including visual inspection, as well as palpation of the lips and an examination of associated cervical, submandibular, and submental nodes. Pathologic and microscopic studies, as well as a review of medications, allergies, and habits, may further highlight possible etiologies. Many lip conditions, including premalignant changes, are relatively easy to treat, when the abnormalities are detected early; however, advanced disease and malignancies are challenging for both the patient and clinician. Treatment should be focused on eliminating potential irritants or allergens and treatment of the primary dermatosis. In this paper we review physiologic variants as well as pathologic conditions of the lips.

Resection of an upper cervical aneurysmal bone cyst and spinal reconstruction using a midline mandibular osteotomy in a pediatric patient.

The authors report on the surgical management of an extensive lesion of the upper cervical spine that required an uncommon transmandibular approach to facilitate exposure, resection, and stabilization in a pediatric patient. A 6-year-old boy with a large aneurysmal bone cyst of the C-2 vertebra presented with progressive weakness and right-sided neck pain. The lesion extended laterally into the soft tissue of the neck, inferiorly to C-4, and posteriorly around the spinal cord. A transmandibular osteotomy was performed to provide adequate exposure for complete resection of the mass and anterior C1-3 instrumentation and fusion. Subsequently, the patient underwent occiput to C-4 posterior instrumentation and fusion. The patient tolerated the operation well and had regained all function at 3 and 11 months' follow-up. No neurological complications or problems of speech, swallowing, or respiration occurred. Even in pediatric patients, the transmandibular approach for the treatment of upper cervical spine lesions is an effective method of maximizing exposure for complex lesions requiring resection and stabilization.

Endovascular thrombectomy following acute ischemic stroke: a single-center case series and critical review of the literature.

Acute ischemic stroke (AIS) due to thrombo-embolic occlusion in the cerebral vasculature is a major cause of morbidity and mortality in the United States and throughout the world. Although the prognosis is poor for many patients with AIS, a variety of strategies and devices are now available for achieving recanalization in patients with this disease. Here, we review the treatment options for cerebrovascular thromboembolic occlusion with a focus on the evolution of strategies and devices that are utilized for achieving endovascular clot extraction. In order to demonstrate the progression of this treatment strategy over the past decade, we will also present a single-center case series of AIS patients treated with endovascular thrombectomy.