The dangers of human papillomavirus (HPV) laser plume and best safety practices.

Human papillomavirus (HPV) remains to be one of the most common viruses that afflicts the skin and mucosa. Direct contact with cutaneous lesions facilitates a majority of viral transmission. However, the development of laser therapy as treatment for HPV brought to attention the concern of infectious laser plume and the risk it poses to those inhaling it. We conducted a literature review using English articles in PubMed to validate this risk and propose the best safety practices dermatologists can apply when using laser therapy as treatment for HPV. Our investigation identified smoke evacuators as primary modes of mitigation, and we suggest further studies will aid in the refinement of best practice recommendations.

The risk of metastases from squamous cell carcinoma of the skin.

Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer, accounting for 20% of all skin cancers. The risk of the disease continues to rise annually with an estimated 50-200% increase in incidence within the last three decades. Although cSCC is one of the most common skin cancers, reported having 1 million cases per year in the United States, there is inconsistency with its reported metastatic rate. Research exploring cSCC metastasis found an overall rate of 1.2-5% but this range varies, and some dermatologists are finding cSCC's ability to spread more worrisome. This allows for clinical variation in the appropriate treatments and follow-up guidelines when diagnosing a patient with cSCC. Poor prognosis in patients with a high metastatic potential makes cSCC clinically problematic. Clinician emphasis should be put on risk factors, anatomical site, tumor presentation, and histological features when evaluating cSCC's metastatic potential. In this review, specific skin conditions that predispose to cSCC and discrepancies in its reported metastatic potential will be discussed.

DMSO: an aid to combat pain and pruritus.

Dimethyl sulfoxide (DMSO) is a highly reactive by-product of paper production in the form of an odorless, colorless liquid that has been studied since the 1860s. Initially it was utilized as a solvent, but more recently it is being investigated for therapeutic applications. Owing to its versatility, the use of DMSO has been proposed in many different medical fields for a variety of applications, with possibly the widest use being in the field of dermatology. The clinical interest in the use of DMSO for dermatology conditions stems from this solution's efficacy as a vehicle to deliver pharmacological agents across the stratum corneum and its ability to penetrate biological membranes. Currently there is only one FDA approval for the use of DMSO, and it is not in the dermatologic field but rather for interstitial cystitis. Outside of the FDA scope of usage, DMSO is used frequently to treat osteoarthritis in humans and animals, as well as other chronic pain conditions. This suggests the possible utility of DMSO being applicable to other inflammatory conditions such as pruritus. Further research is necessary to explore the promising utilization opportunities of DMSO in dermatology.

Pain and Pruritus: a study of their similarities and differences.

Pruritus is one of the most common dermatologic complaints and, as the most common dermatologic symptom, is a major contributor to frequent dermatology visits. Chronic pruritus mirrors another major medical condition faced by millions of Americans each year - chronic pain. In older literature, pain and pruritus were thought to have been conveyed by the same C fiber, and the proportion contributing to pruritus was just a small subset of this general fiber. Overall, pain and pruritus share many integral similarities. Although these sensations both initiate the body's awareness to injury, pain and itch may have evolved for sensing different damages such as a burrowing parasite or a noxious stimulus, respectively. This seems to have been validated through analyses of their pathophysiology, acute and chronic conditions, and treatment modalities. However, their symptoms and intrinsic mechanisms vary considerably. It is important to view pruritus in more of an overall, whole body experience, rather than just the sensory aspect. Future studies should investigate the psychological treatment of chronic pruritus, considering the immense similarities with its chronic pain counterpart.

Airborne contact dermatitis: common causes in the USA.

Airborne contact dermatitis (ABCD) is an inflammatory reaction involving the skin upon exposure to allergenic agents or irritants suspended in air. In allergic ABCD, the hypersensitivity is classified as a type IV reaction. Substances responsible for such reactions can be of plant or non-plant origin. Commonly reported plants include those of the Compositae family, which includes ragweed, goldenrod, and sunflowers. Establishing an accurate diagnosis is critical for preventing exposure and improving symptoms in patients. Obtaining a detailed history and performing a physical examination to determine the sites of involvement, as well as patch testing to establish the causative allergen, are the main methods of arriving at the correct diagnosis. Treatment often involves avoidance of the allergens or irritants when possible and may also include the application of topical barrier creams or systemic therapy in more severe cases. This article reviews the topic of ABCD and highlights its most common etiologies in the USA.

Sunscreen regulations and use of anti-inflammatory agents in sunscreens.

The Food and Drug Administration (FDA) has been more proactive in regulating sunscreen products. In 2011, the FDA publicized a set of new requirements for marketing over-the-counter sunscreens in the United States. The primary goal of the new FDA requirements was to provide consumers with a clear understanding of the level of protection actually provided by a sunscreen. Furthermore, information about protection against ultraviolet A radiation, associated with early aging and skin cancer, was to be clarified. With the new regulations, sunscreen products that provide protection against ultraviolet A and ultraviolet B would be allowed to be marketed as broad-spectrum sunscreen [1].

Cryosurgical treatment of warts: dimethyl ether and propane versus liquid nitrogen - case report and review of the literature.

For years, dermatologists have relied on cryotherapy with liquid nitrogen as a safe and effective treatment for warts. More recently, several over-the-counter (OTC) wart-freezing therapies have become available. Manufacturers have substituted liquid nitrogen with dimethyl ether and propane (DMEP), and marketed these new preparations to be safe and effective alternatives to in-office cryotherapy with liquid nitrogen. However, data from in vitro studies and comparative studies in humans refute manufacturers' claims that these products reproduce in-office cryotherapy.

Identifying potential pitfalls in conventional herpes simplex virus management.

In recent years, it has become increasingly clear that genital ulcers from herpes simplex virus (HSV) are associated with HIV acquisition. In light of this evolving synergy in transmission and the availability of effective antiviral therapy, proper diagnosis and management of HSV becomes increasingly important. Unfortunately, conventional HSV management is founded on several popular misconceptions. Herein, we hope to dispel these common misconceptions and expand the current model of herpetic reactivation. By doing so, we aimed to unveil potential pitfalls in current herpetic management.

Herpes and acoustic neuromas: is there a cause and effect to observe?

Acoustic neuromas are a result of damage to the affected nerve function and can potentially press surrounding tissues. Although some sources suggest that observation is the treatment of choice for only those over 65 years of age and those unable to tolerate undergoing surgery or radiosurgery, most affected individuals should strongly consider not doing any aggressive therapies. Herpes has already been shown to mimic acoustic neuroma clinically, but growing evidence suggests that it is likely the cause of most cases of this entity.