Australasian Journal of Dermatology via MedWorm.com

Effect of inflammation on positive margins of basal cell carcinomas

Australasian Journal of Dermatology — Fri, 12 Mar 2010 00:00:00 +0100

Conclusion: The study has shown the majority of negative re-excisions were from lesions on the head which had had an initial surgical procedure. However, the evidence is not strong enough to advocate a protocol for dealing with positive margins. A larger sample size that encompassed all three factors that affect outcome, that is, the location of lesion, type of lesion and type of excision carried out, would be required in order to make a more definitive statement on protocol change for treatment of basal cell carcinoma. (Source: Australasian Journal of Dermatology)

PEP005 (ingenol mebutate) gel for the topical treatment of superficial basal cell carcinoma: Results of a randomized phase IIa trial

Australasian Journal of Dermatology — Thu, 11 Mar 2010 00:00:00 +0100

Conclusions: Two applications of ingenol mebutate gel, 0.05%, are safe and have efficacy in patients with superficial basal cell carcinoma. (Source: Australasian Journal of Dermatology)

Childhood and adolescent orofacial granulomatosis is strongly associated with Crohn's disease and responds to intralesional corticosteroids

Australasian Journal of Dermatology — Thu, 11 Mar 2010 00:00:00 +0100

We present seven cases of orofacial granulomatosis occurring in paediatric patients aged 6[ndash]16 years. All patients were investigated for Crohn's disease and a strong association was found. All patients were treated with intralesional corticosteroid injections with excellent clinical responses. We review the literature and discuss the epidemiological association between childhood orofacial granulomatosis and Crohn's disease, as well as various treatment options, and propose a treatment protocol that was efficacious and well tolerated in all our patients. (Source: Australasian Journal of Dermatology)

A case of congenital solitary Langerhans cell histiocytoma

Australasian Journal of Dermatology — Sat, 27 Feb 2010 00:00:00 +0100

A newborn baby boy was referred to the Paediatric Dermatology Unit with a solitary asymptomatic nodule overlying his right nasolabial fold. Complete physical examination, full blood count, serum chemistry, liver function tests and baseline imaging were unremarkable. Histopathological examination showed an atypical dermal infiltrate of mononuclear cells that stained positive with CD1a and S100. A diagnosis of congenital solitary Langerhans cell histiocytoma was made. The lesion completely resolved by 4 months of age. The baby is now 15 months old and repeat systemic evaluation has remained normal. (Source: Australasian Journal of Dermatology)

A randomized, assessor-blind, parallel-group, multicentre, phase IV comparative trial of a suffocant compared with malathion in the treatment of head lice in children

Australasian Journal of Dermatology — Fri, 26 Feb 2010 00:00:00 +0100

Conclusions: The suffocant is shown to be significantly more effective in eliminating head lice than malathion in children, while being associated with a low incidence of mild, transient adverse events. (Source: Australasian Journal of Dermatology)

Hidradenitis suppurativa responding to treatment with infliximab

Australasian Journal of Dermatology — Fri, 26 Feb 2010 00:00:00 +0100

A series of four cases of severe recalcitrant hidradenitis suppurativa treated with infliximab is presented. All patients had failed to respond to prior medical and surgical management. Baseline Quantiferon-TB Gold and chest radiograph were carried out before commencement of treatment. No patients had associated Crohn's disease. All patients received induction infusions of infliximab 5 mg/kg at weeks 0, 2 and 6, followed by eight weekly maintenance infusions. The total number of infusions varied between 4 and 6. Skin photography with Sartorius scoring was used to evaluate response to treatment. All patients experienced marked improvement in their disease activity, with a mean 48% improvement in Sartorius score after one infusion (week 2, P < 0.01), and 70% improvement after three infusions...

Metastatic Merkel cell carcinoma with an unknown primary tumour presenting as lichenoid dermatitis

Australasian Journal of Dermatology — Fri, 26 Feb 2010 00:00:00 +0100

We report a patient who first presented with lichenoid dermatitis and was found to have Merkel cell carcinoma involving lymph nodes with an unknown primary site. With the rising incidence of Merkel cell carcinoma, it is important to recognize unusual manifestations of this disease as they may become more common in the future. (Source: Australasian Journal of Dermatology)

Facial porokeratosis: A series of six patients

Australasian Journal of Dermatology — Tue, 23 Feb 2010 00:00:00 +0100

We present six cases of facial porokeratosis seen over a period of 15 years in a hospital in Lima, Peru. In most of the cases, porokeratosis was found in younger women without any significant past medical history. Oral isotretinoin showed moderate improvement in two of our patients. (Source: Australasian Journal of Dermatology)

Dystrophic calcification following neonatal heel-prick testing

Australasian Journal of Dermatology — Mon, 22 Feb 2010 00:00:00 +0100

A 7-year-old boy presented with a 5-year history of dystrophic calcification manifesting as solitary nodules on the plantar aspect of both heels. Microscopic examination showed hyperkeratosis and psoriasiform hyperplasia overlying an area of dystrophic calcification. Multiple heel-prick tests carried out during the neonatal period to monitor blood glucose levels are the likely causative mechanism. (Source: Australasian Journal of Dermatology)

Trigeminal trophic syndrome treated with thermoplastic occlusion

Australasian Journal of Dermatology — Mon, 22 Feb 2010 00:00:00 +0100

A 72-year-old man with a history of thrombotic CVA causing lateral medullary infarction presented with non-healing ulcers of the right side of the face of 5 months' duration. After extensive investigations, a diagnosis of trigeminal trophic syndrome was made. The ulcers progressed relentlessly despite amitriptyline and gabapentin, and he was treated with a combination of carbamazepine and thermoplastic mask occlusion of the right side of his face. Over the next 10 weeks the shallower facial ulcers began to diminish in depth and diameter, and the deeper ulcers stopped progressing. Although the patient showed early signs of healing, he died because of complications from the CVA. (Source: Australasian Journal of Dermatology)

Bowel bypass syndrome/bowel-associated dermatosis arthritis syndrome post laparoscopic gastric bypass surgery

Australasian Journal of Dermatology — Mon, 22 Feb 2010 00:00:00 +0100

Bowel bypass syndrome, also known as bowel-associated dermatitis arthritis syndrome, has been described after a range of intestinal bypass procedures. With the increasing trend in laparoscopic gastric bypass surgery, we report an interesting case of bowel-associated dermatitis arthritis syndrome that developed 12 months following this procedure. A 49-year-old woman presented with ulcerating lesions and pustules on the upper and lower limbs, polyarthralgia, fevers and joint effusions. Before the development of these symptoms she was well, with no significant past medical or family history. A skin biopsy taken from the left shin showed superficial to mid-dermal neutrophilic dermatosis, consistent with bowel-associated dermatitis arthritis syndrome. The patient received corticosteroids, antib...

Annular erythema as a sign of recurrent breast cancer

Australasian Journal of Dermatology — Tue, 02 Feb 2010 00:00:00 +0100

Three women with known breast cancer presented with very similar annular erythemas of their chest walls. All women were in remission from their breast cancer for at least 6 months. Their breast cancers had initially responded well to multi-modality treatment with no clinical or radiologic evidence of recurrence, until the development of the annular erythema. In the first case, the annular erythema was treated unsuccessfully as a dermatitis and then as tinea corporis. In the second case, subacute cutaneous lupus was considered but lupus antibodies were negative. In the third case, the annular erythema was promptly recognized and biopsied. Histology in all three cases revealed identical findings of invasive ductal carcinoma involving the lymphatics of the skin. Immunohistochemical staining o...

Bilateral tibialis anterior muscle herniation simulating a soft tissue tumour in a young amateur football player

Australasian Journal of Dermatology — Mon, 01 Feb 2010 00:00:00 +0100

We report a case of bilateral tibialis anterior muscle herniation mimicking a soft tissue tumour in a young amateur football player. (Source: Australasian Journal of Dermatology)

Early-stage testicular cancer: A rare association with dermatomyositis

Australasian Journal of Dermatology — Mon, 01 Feb 2010 00:00:00 +0100

We report a case of dermatomyositis occurring in early-stage testicular cancer where the patient was in remission. It stresses the importance of considering testicular cancer as an association with dermatomyositis, as it is a potentially curable malignancy. (Source: Australasian Journal of Dermatology)

Allergic contact dermatitis to propyl gallate and pentylene glycol in an emollient cream

Australasian Journal of Dermatology — Mon, 01 Feb 2010 00:00:00 +0100

A 62-year-old man, with a 20-year history of seborrhoeic dermatitis, presented with a worsening of his dermatitis. He had previously been demonstrated to be allergic to various topical corticosteroids, so he had been using an emollient cream (Sebclair®), containing piroctone olamine and various anti-inflammatory substances, for 6 months, with good effect. Patch testing to the cream and its ingredients revealed positive reactions to both propyl gallate and pentylene glycol. A positive reaction to propylene glycol was also detected, whereas patch testing to butylene glycol was negative. Complete remission followed avoidance of the offending substances. (Source: Australasian Journal of Dermatology)

Extramammary Paget's disease involving the penis, scrotum and the axilla

Australasian Journal of Dermatology — Mon, 01 Feb 2010 00:00:00 +0100

A 57-year-old man with a 2-year history of extramammary Paget's disease of the penis, scrotum and the axilla attended our urology clinic. The lesion in the axilla had been noticed 14 months later than the lesion involving the penis and scrotum. We performed a resection of both local extramammary Paget's disease lesions with a 3-cm margin. Intraoperative frozen sections were also used to ascertain clear surgical margins. Neither signs of recurrence nor underlying internal malignancy has developed after 2-year follow up. From our experience, extramammary Paget's disease may occur in multiple sites. In the absence of metastatic disease and underlying internal malignancy, a wide excision is recommended in the management of multiple lesions of extramammary Paget's disease. (Source: Australasian...

Dermoscopic presentation of a 2-mm melanoma in situ

Australasian Journal of Dermatology — Mon, 01 Feb 2010 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Isolated symptomatic cutaneous disease in hypereosinophilic syndrome

Australasian Journal of Dermatology — Mon, 25 Jan 2010 00:00:00 +0100

A 41-year-old Phillipino man presented with a 3-year history of a relapsing and remitting generalized chronic pruritic erythematous papular and plaque-like eruption. Investigations showed a persistently elevated eosinophil count. His disease was limited to cutaneous involvement with an absence of demonstrable internal organ involvement, despite extensive investigations and multidisciplinary review. Other causes of eosinophilia were excluded. A diagnosis of idiopathic hypereosinophilic syndrome was made. Our patient's presentation raises a number of issues related to hypereosinophilic syndrome. In particular, relating to managing hypereosinophilic syndrome and the challenge of minimizing therapy side-effects. Our case highlights the considerable morbidity of untreated isolated cutaneous dis...

Peripheral nerve field stimulation for pruritus relief in a patient with notalgia paraesthetica

Australasian Journal of Dermatology — Sun, 24 Jan 2010 00:00:00 +0100

This case study is presented to exemplify the application of peripheral nerve field stimulation in the treatment of recalcitrant notalgia paraesthetica. The patient was a 60-year-old woman with severe and disabling notalgia paraesthetica. The itch persisted despite the use of several medications [ndash] topical and oral. Following a successful trial of peripheral nerve field stimulation with a temporary electrode, two subcutaneous electrodes were inserted into the affected area with a battery implanted subcutaneously in her right buttock. The patient was reviewed at 5 months post implantation. She reported a greater than 85% improvement in her itch. She also reported a major improvement in her quality of life, with particular improvement in her ability to sleep through the night. This case...

A dermoscopic case of 'naevus of special sites'

Australasian Journal of Dermatology — Sun, 24 Jan 2010 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Hyaluronic acid filler injections with a 31-gauge insulin syringe

Australasian Journal of Dermatology — Sun, 24 Jan 2010 00:00:00 +0100

Hyaluronic acid gel is a commonly used skin/soft tissue filler in cosmetic dermatology. Hyaluronic acid fillers are packaged in proprietary luer-lock syringes that can be injected via a 30-gauge, 27-gauge or larger diameter needle depending on the consistency of the gel. A method of decanting proprietary hyaluronic acid fillers into multiple 31-gauge insulin syringes for injection is described. The use of a 31-gauge insulin syringe for filler injections can potentially enhance the injection process through more accurate product delivery and placement. This has the potential to produce a more balanced and symmetrical outcome for patients. Additional benefits include less injection pain, less bleeding/bruising and higher levels of patient satisfaction. (Source: Australasian Journal of Dermat...

Pediatric Dermatology –Requisites in Dermatology

Australasian Journal of Dermatology — Sun, 24 Jan 2010 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Braun-Falco' Dermatology

Australasian Journal of Dermatology — Sun, 24 Jan 2010 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Editorial

Australasian Journal of Dermatology — Sun, 24 Jan 2010 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Requisites in Dermatology: Dermatopathology, 1st ed

Australasian Journal of Dermatology — Sun, 24 Jan 2010 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

The potpourri approach to hyaluronic acid filler injections

Australasian Journal of Dermatology — Wed, 20 Jan 2010 00:00:00 +0100

There is an ever-expanding range of hyaluronic acid fillers with varying physical characteristics available to cosmetic dermatologists. These fillers are commercially packaged in syringes of approximately 1 mL (range 0.5[ndash]2 mL) volume. Filler injectors are currently qualitatively and quantitatively restricted to fillers packaged in ready-to-go syringes. Patients often present for pan-facial rejuvenation requiring varying amounts of fillers as well as more than one type/subtype of filler for optimum correction. The potpourri approach allows access to a range of prepared hyaluronic acid filler subtypes that can be used on the same patient in the one session. The potpourri method centres on the use of multiple 31-gauge insulin syringes prepared with a range of different hyaluronic acid f...

Rapid resolution of primary vulval adult Langerhans cell histiocytosis with very potent topical corticosteroids

Australasian Journal of Dermatology — Tue, 29 Dec 2009 00:00:00 +0100

We report a 62-year-old female patient presenting with an 18-month history of pruritus and burning of the vulva. Clinical examination of the vulva showed a tender nodule of the right labium minus. Histology confirmed Langerhans cell histiocytosis. Systemic involvement was excluded. Within 1 month the use of clobetasol propionate ointment led to resolution of both the patient's symptoms and the clinical appearance of the affected right labium minus. This resolution was maintained 12 months later. (Source: Australasian Journal of Dermatology)

Nickel allergy presenting as mobile phone contact dermatitis

Australasian Journal of Dermatology — Mon, 28 Dec 2009 00:00:00 +0100

A 39-year-old man presented with a 6-month history of a treatment-resistant facial dermatitis. The patient regularly used his mobile phone, predominantly on the left cheek. Patch testing confirmed the clinical suspicion of mobile phone contact dermatitis from nickel contained in the phone casing. Although infrequently reported, with the trend towards metallic mobile phone casings and the high incidence of nickel sensitization in the community, the incidence of mobile phone contact dermatitis is likely to increase. (Source: Australasian Journal of Dermatology)

Unilateral Beau's lines associated with a fractured olecranon

Australasian Journal of Dermatology — Mon, 28 Dec 2009 00:00:00 +0100

We report a case of unilateral Beau's lines developing after an olecranon fracture of the right elbow. Unilateral Beau's lines are an uncommon phenomenon but have been previously reported after trauma to the wrist, hands, forearm and elbow. (Source: Australasian Journal of Dermatology)

Acute unilateral poliosis concurrent with trigeminal autonomic cephalalgia: A possible aetiological association

Australasian Journal of Dermatology — Mon, 28 Dec 2009 00:00:00 +0100

We report a 24-year-old man who presented with the sudden onset of unilateral poliosis associated with acute trigeminal autonomic cephalalgia, suggesting a pathophysiology in common and a possible neural hypothesis in the development of segmental vitiligo. Although rare, associations with neurological abnormalities should be considered in cases of focal depigmentation disorders. (Source: Australasian Journal of Dermatology)

Erosive pustular dermatosis of the leg: Long-term control with topical tacrolimus

Australasian Journal of Dermatology — Mon, 28 Dec 2009 00:00:00 +0100

We report the cases of two women who developed erythematous skin plaques with pustules that coalesced and evolved into erosions and crusted areas. Histology showed epidermal spongiosis with subcorneal pustules and a dermal infiltrate with eosinophils and neutrophils. Lesions were treated with topical clobetasol propionate 0.05% for 10 days followed by topical tacrolimus daily until complete resolution, and then twice weekly for 1 year, without relapse. The response to topical corticosteroids and tacrolimus further support the close relationship with erosive pustular dermatosis of the scalp. Topical therapy with tacrolimus may offer good long-term disease control. (Source: Australasian Journal of Dermatology)

Short-term morbidity associated with sentinel lymph node biopsy in cutaneous malignant melanoma

Australasian Journal of Dermatology — Thu, 17 Dec 2009 00:00:00 +0100

Guidelines for the surgical treatment of cutaneous primary malignant melanoma are well established; however, the approach to the treatment of the regional lymph nodes remains more controversial. In many centres, sentinel lymph node biopsy has been adopted as routine in the treatment of malignant melanoma for prognostic purposes, as it is not of proven therapeutic benefit. The Multicentre Selective Lymphadenectomy Trial II aims to determine the comparative benefits of subsequent completion lymphadenectomy versus observation in those found to have a positive sentinel node biopsy. Until results are available, the risks of the procedure must be weighed against the value of prognostic information gained from performing a sentinel node biopsy. In this retrospective analysis of sentinel lymph nod...

Managing patients with cutaneous squamous cell carcinoma metastatic to the axilla or groin lymph nodes

Australasian Journal of Dermatology — Thu, 17 Dec 2009 00:00:00 +0100

Cutaneous squamous cell carcinoma accounts for 20% of all non-melanoma skin cancer with a minority arising on the trunk and extremities. A small proportion will develop metastases to regional nodes of the axilla or groin. We performed a retrospective review of patients with metastatic cutaneous squamous cell carcinoma to the axilla and groin treated at Westmead Hospital, Sydney. The purpose of this study was to document the treatment and outcome of these patients. We identified 18 men and 8 women with a median age of 73 years. Median follow-up was 18.5 months. Median lesion size was 27 mm (range 3[ndash]130 mm) and median thickness was 7 mm (range 3[ndash]32 mm). Nine patients developed metastases to the groin, 14 to the axilla, 1 in the epitrochlear, and 2 to both the epitrochlear and axi...

Many faces of graft-versus-host disease

Australasian Journal of Dermatology — Thu, 17 Dec 2009 00:00:00 +0100

Allogeneic haematopoietic stem cell transplantation is increasingly used in the treatment of malignant and non-malignant disorders. Despite ongoing advances in the field, morbidity and mortality related to graft-versus-host disease remains a major barrier to its application. Graft-versus-host disease is a difficult-to-diagnose disease. Dermatologists are involved due to its diverse cutaneous expression. In order to appropriately diagnose, classify and treat this complex disease, knowledge of its expanding cutaneous expression is required. This review provides a synopsis of the clinical manifestations of acute, lichenoid and sclerodermatous phases of graft-versus-host disease with a look at the current evidence surrounding its differential diagnosis. (Source: Australasian Journal of Dermato...

The use of intravenous immunoglobulin for treatment of dermatological conditions in Australia: A review

Australasian Journal of Dermatology — Thu, 17 Dec 2009 00:00:00 +0100

Intravenous immunoglobulin has been used in the treatment of various dermatological conditions, including toxic epidermal necrolysis, bullous pemphigoid and pemphigus vulgaris. From March 2008, the National Blood Authority has implemented the 'Criteria for the clinical use of intravenous immunoglobulins in Australia'. The new criteria have formalized the eligibility requirements for several dermatological conditions. This may increase access to intravenous immunoglobulin for treatment for these conditions. However, there remain stringent eligibility criteria with which dermatologists need to be acquainted. In some conditions, dermatology review is mandated by these criteria while in other conditions with skin manifestations, referral to other specialists is required. The following article ...

Genetics of basal cell carcinoma

Australasian Journal of Dermatology — Fri, 11 Dec 2009 00:00:00 +0100

Basal cell carcinoma is the most common human malignancy in populations of European origin, and Australia has the highest incidence of basal cell carcinoma in the world. Great advances in the understanding of the genetics of this cancer have occurred in recent years. Mutations of the patched 1 gene (PTCH1) lead to basal cell carcinoma predisposition in Gorlin syndrome. PTCH1 is part of the hedgehog signalling pathway, and derangements within this pathway are now known to be important in the carcinogenesis of many different cancers including sporadic basal cell carcinoma. The molecular biology of the hedgehog pathway is discussed, and mouse models of basal cell carcinoma based on this pathway are explored. New developments in non-surgical treatment of basal cell carcinoma are based on this ...

New Zealand Dermatological Society Incorporated Annual Scientific Meeting

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Erratum

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Mervyn roy gold

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Cosmetic Dermatology: Requisites in Dermatology

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

General Dermatology: Requisites in Dermatology

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Outcomes of Skin Surgery

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Dermoscopy of Hair and Scalp Disorders: With Clinical and Pathological Correlations

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Trichilemmal cyst with homogeneous blue pigmentation on dermoscopy

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

A 61-year-old woman was referred to our dermoscopy unit for a pigmented lesion that had been present on her left arm for 8 years. The patient did not notice any enlargement or change in colour. On dermoscopy, homogeneous blue pigmentation was seen. The lesion was excised with the pre-operative diagnosis of melanoma, blue naevus and dermatofibroma. Histopathological examination showed a trichilemmal cyst in the mid-dermis. Although homogeneous blue pigmentation on dermoscopy is the hallmark of blue naevus, it may be seen in metastatic melanoma and exceptionally in hemosiderotic and cellular types of dermatofibroma. Trichilemmal cyst should be borne in mind also in the dermoscopic differential diagnosis. (Source: Australasian Journal of Dermatology)

In other journals

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Letters to the editor

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Letters to the editor

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Cutaneous malignant melanoma arising in an acquired naevus of Ota

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

We describe a 32-year-old Caucasian man with an acquired naevus of Ota with subtle pigmentation, in which a melanocytic papule developed. The lesion, deceptively, had no clinically suspicious features, but investigation revealed an aggressive cutaneous malignant melanoma, extensive orbital ring melanocytosis and metastatic brain and subsequent liver disease. (Source: Australasian Journal of Dermatology)

Rhinophyma: Carbon dioxide laser with computerized scanner is still an outstanding treatment

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

This report demonstrates excellent cosmetic results and no major postoperative complications or recurrence of the condition after 1 year of follow up for seven patients. Two more patients had been followed up for 1 month at the time this paper was written. Scanned carbon dioxide laser is safe and highly effective treatment for rhinophyma. (Source: Australasian Journal of Dermatology)

Sézary syndrome presenting with 'leonine facies'

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

A 71-year-old man presented with erythroderma and multiple nodular skin lesions over the face, scalp, upper limbs and trunk. The facial skin was thickened, producing the rare 'leonine facies' appearance. Investigations revealed the presence of atypical lymphoid cells in the peripheral blood, bone marrow and skin. The atypical lymphoid cells in the peripheral blood and bone marrow were positive for helper T-cell antigens (CD4, CD2, CD5 and CD7) on immunophenotyping by flow cytometry. The histopathology of skin showed dermal infiltration by atypical small lymphocytes with epidermotropism. These cells were positive for helper T-lymphocyte antigens on immunohistochemistry. A diagnosis of Sézary syndrome was made based on clinical, peripheral blood and immunophenotypical findings. (Source: Aus...

Diagnosis of type I cryoglobulinaemia made through identifying crystals in the blood smear

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

We report a case of type I cryoglobulinaemia in a 52-year-old man who presented with widespread cutaneous necrosis. The diagnosis could not be established early on, as repeated testing for cryoglobulin was negative despite a careful collection method. The diagnosis was made 1 year later, on an incidental full blood smear that revealed crystals, which is an uncommon way to diagnose this condition. We discuss the difficulties we faced in establishing the diagnosis and emphasise the need for repeat cryoglobulin testing in this clinical setting. In such cases, examination of a blood smear should be considered. (Source: Australasian Journal of Dermatology)

Chronic localized intravascular coagulation complicating multifocal venous malformations

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

We present two female children aged 7 years with extensive multifocal venous malformations complicated by chronic localized intravascular coagulation. In both cases ultrasonography and magnetic resonance imaging revealed extensive venous malformations involving the skin, mucous membranes and pharynx, which were not apparent on clinical examination. Haematological investigations demonstrated persistent elevation of the D-dimer, consistent with chronic localized intravascular coagulation. The course of one patient was complicated by the development of multiple painful thromboses at distant sites following percutaneous sclerotherapy. Persistent elevation of the D-dimer occurring in association with large venous and veno-lymphatic malformations has been termed chronic localized intravascular c...

Childhood ocular rosacea: Considerations for diagnosis and treatment

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

We report three cases of paediatric ocular rosacea responding to prolonged treatment with oral erythromycin. Our cases demonstrate the close association of periorificial dermatitis with childhood rosacea, and highlight the importance of eye signs in its diagnostic criteria. (Source: Australasian Journal of Dermatology)

Topical diphencyprone immunotherapy for cutaneous metastatic melanoma

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

Topical immunotherapy with contact sensitizers for metastatic melanoma was first reported more than 30 years ago. Diphencyprone (DPCP) immunotherapy is frequently used to treat cutaneous warts and alopecia areata, and we have previously reported the use of DPCP as a single agent to successfully treat extensive, radiotherapy-resistant melanoma metastases on the scalp. We now report DPCP treatment of a further six patients with cutaneous metastatic melanoma. Of seven patients treated with DPCP thus far, four have demonstrated complete responses of their cutaneous lesions and three have had partial responses. The treatment was well-tolerated by all patients. Topical immunotherapy with DPCP is inexpensive and relatively non-invasive and should be considered in patients with locally advanced sk...

Cutaneous invasive squamous cell carcinoma: 10-year experience and recommendations for follow up

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

Currently, the National Health and Medical Research Council do not have any recommendations about the frequency of follow up after treatment of primary cutaneous invasive squamous cell cancer (SCC), due to a lack of data. The present study aimed to establish appropriate follow-up times and to determine the long-term risk of subsequent non-melanoma skin cancers and melanoma. Patients who had a primary invasive cutaneous SCC excised during 1996 were retrospectively identified from the databases of a dermatologist in private practice in south-east Queensland. Data on size, site, depth, differentiation, perineural involvement, lymphovascular involvement of the index SCC were obtained. The patients were regularly followed up and lymph-node involvement, patient immunocompetence, and the presence...

Melanoma in private practice: Do dermatologists make a difference?

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

Malignant melanoma is a major contributor to Australian morbidity and mortality. In this era of resource rationalisation, we seek to address the issue of whether routine full-skin examination by a dermatologist, rather than focussed examination of flagged lesions, will increase melanoma diagnosis. A retrospective chart review was undertaken between 1 July 2007 and 30 June 2008 in a private dermatology group practice in order to ascertain the number and characteristics of incidentally detected melanomas on routine skin examination. A total of 94 melanomas were detected during this 12-month period. Of these, 57 (60.6%) were incidentally detected by the dermatologist, 41 (71.9%) were in situ melanomas and 16 (28.1%) were invasive melanoma. Of the invasive lesions, 15 (94%) were 'thin' (less t...

Role of definitive radiotherapy in treating patients with inoperable Merkel cell carcinoma: The Westmead Hospital experience and a review of the literature

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

We report the results of eight patients with inoperable MCC treated with RTx alone between 1993 and 2007 at Westmead Hospital, Sydney, Australia, and also review the relevant literature on definitive RTx in the treatment of MCC. The median age at diagnosis was 82.5 years in five women and three men. All patients were Caucasian and none were immunosuppressed. Seven of eight patients were clinically node-positive. The mean duration of follow up was 12 months. A median dose of 50 Gy was prescribed. Seven of eight patients with inoperable MCC achieved in-field control, with most eventually relapsing distantly. Treatment-related toxicity was acceptable. In keeping with our results, other studies also report high rates of in-field locoregional control following RTx alone. These findings highligh...

Paediatric vulval lichen sclerosus

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

Lichen sclerosus (LS) in children is uncommon; however, it is an important differential diagnosis in any pre-pubertal child presenting with chronic vulval symptoms. The long-term prognosis is unknown; however, recent data suggests that the assumption that the condition will resolve at puberty may be incorrect. Children with LS require long-term management with topical corticosteroids, which remains the treatment of choice, as well as long-term follow up. We review the current literature on paediatric vulval LS. (Source: Australasian Journal of Dermatology)

Select the most correct answers – multiple answers possible for questions 1–11

Australasian Journal of Dermatology — Wed, 04 Nov 2009 00:00:00 +0100

(Source: Australasian Journal of Dermatology)

Congenital melanocytic naevi

Australasian Journal of Dermatology — Sun, 01 Nov 2009 00:00:00 +0100

, consisting of clusters of naevo-melanocytes, develop in utero. Although many congenital naevi are visible at birth, some may not become evident until later in life. The timing of naevo-melanocyte proliferation, senescence and melanogenesis may all contribute towards determining when a naevus will become clinically manifest on the skin. Besides the fact that congenital melanocytic naevi may be aesthetically displeasing, resulting in a multitude of psychosocial issues, they also increase the risk for developing cutaneous melanoma, leptomeningeal melanoma, neurocutaneous melanocytosis, malformations of the brain and, rarely, other tumours such as rhabdomyosarcoma and liposarcoma. Whereas the risk of developing malignancy in association with congenital naevi is dependent, to some extent, on ...

Biennial Spring Conference

Australasian Journal of Dermatology — Tue, 01 Sep 2009 11:59:31 +0100

(Source: Australasian Journal of Dermatology)

Author Index 2009

Australasian Journal of Dermatology — Sun, 30 Aug 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Conditions masquerading as infantile haemangioma: Part 2

Australasian Journal of Dermatology — Thu, 23 Jul 2009 10:50:46 +0100

Infantile haemangiomas are among the most common growths during infancy. Their rapid growth during infancy and vascularity can easily cause confusion with other, less common growths. Part I focussed on other vascular anomalies that can mimic infantile haemangiomas. Part II emphasizes benign growths and malignant conditions that can also cause diagnostic confusion. (Source: Australasian Journal of Dermatology)

Dermatology: Fundamentals of Practice

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Dermatopathology

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Unusual clinical and dermoscopic presentation of a wart

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

In other journals

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Letters to the editor

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Letters to the editor

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Primary umbilical melanoma

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

We report a 72-year-old woman who presented with a primary melanoma of the umbilicus and periumbilical skin of 4 years' duration. Pathological examination of a biopsy specimen showed Clark's level IV, and tumour thickness 2.3 mm. The patient underwent preoperative lymphatic mapping followed by sentinel lymph node biopsy, and wide local excision of the primary tumour, including its attachment to the peritoneum. Because of the variations in vascularity and the residual embryonal connections of the umbilicus with the peritoneum and other intra-abdominal organs, an aggressive surgical approach is recommended in the management of malignant umbilical tumours. (Source: Australasian Journal of Dermatology)

Granuloma faciale successfully treated with topical tacrolimus

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

We report a man with a 6-month history of plaques on his forehead and preauricular area consistent with GF that responded to twice-daily application of topical tacrolimus ointment, and who remains in remission 1 year later. This case supports previous reports of the successful use of topical tacrolimus in treating GF. (Source: Australasian Journal of Dermatology)

Repigmentation and curling of hair after acitretin therapy

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

We describe a 70-year-old woman with psoriasis who noticed darkening of her previously white hair, which also gained a curly appearance after 6 months of acitretin treatment. We present this case to emphasize that acitretin can be added to the list of drugs that induce changes in hair colour and texture. (Source: Australasian Journal of Dermatology)

Vitiligo-like depigmentation induced by imiquimod treatment of superficial basal cell carcinoma

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

A 61-year-old man was treated with imiquimod 5% cream for superficial basal cell carcinoma, five times per week for 13 weeks. This resulted in vitiligo-like depigmentation and poliosis in the area of treatment. This rare side-effect has been noted in previous case reports of imiquimod treatment for both genital warts and superficial basal cell carcinoma. This highlights the importance of such a side-effect being discussed with the patient who is to be treated with imiquimod, particularly in cosmetically sensitive areas. (Source: Australasian Journal of Dermatology)

Toxic epidermal necrolysis and neutropaenia: Complications of omeprazole

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

Worldwide, proton pump inhibitors (PPI) are one of the most frequently prescribed drugs; however, up to 70% of patients taking these drugs have no appropriate indication. Although PPI are relatively well tolerated, they are not free from side-effects and several life-threatening complications are associated with them. In the present report, a 43-year-old woman presented to her general practitioner with an erythematous rash over her face and chest, having been started on omeprazole for chronic abdominal bloating. Over the next 24 h she became increasingly unwell and was admitted to hospital with shortness of breath, pyrexia and the rash spreading over her back, arms and legs. Vesicles had now started to appear within the erythematous regions over her upper body and within 24 h the rash beca...

Refractory subacute cutaneous lupus erythematosus successfully treated with rituximab

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

A 48-year-old woman presented with pruritic, scaly, annular plaques over her upper back and chest that were clinically, serologically and histologically characteristic of subacute cutaneous lupus erythematosus (SCLE). She failed to respond to conventional treatment, which included high-dose hydroxychloroquine, methotrexate, prednisolone, chloroquine, acitretin, thalidomide, dapsone and azathioprine. Subsequently treated with intravenous rituximab 375 mg/m2 weekly for 4 weeks, she remained on adjuvant oral hydrochloroquine 600 mg daily and topical clobetasol propionate 0.05% ointment as required. Clearing of annular plaques was noted 8 weeks after the initial course of rituximab. By 12 weeks there were no new lesions and only post-inflammatory hyperpigmentation remained. Both hyper- and hyp...

Indurated reticulate palmar erythema as a sign of paraneoplastic palmar fasciitis and polyarthritis syndrome

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

A 62-year-old woman presented with a 6-month history of polyarthritis. She had also noted a 2-month history of indurated palmar erythema and increasing bilateral hand swelling and stiffness. A biopsy from the area of palmar erythema showed interstitial fibroplasia within the dermis and subcutis representing a palmar fibromatosis. This presentation appears to belong to the spectrum of palmar fasciitis and polyarthritis syndrome. Rheumatologists have recognised this syndrome as a paraneoplastic disorder and subsequent investigations in our patient revealed an elevated cancer antigen 125 and an inoperable ovarian carcinoma. Indurated palmar erythema is a sign that is not widely recognised by dermatologists as a clue for this paraneoplastic syndrome, and skin biopsy demonstrating dermal and su...

Recurrent keratoacanthoma with vascular invasion: A diagnostic and management dilemma

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

A 71-year-old man with chronic renal failure and on peritoneal dialysis presented with recurrence of multiple keratotic nodules along a surgical scar. This was 6 months after the excision of a recurrent keratotic nodule reported as squamous cell carcinoma from the same site. The lesions were initially reported as squamous cell carcinomas, but on review of histology were consistent with keratoacanthomas. One of the keratoacanthomas showed vascular invasion. These responded well to low-dose acitretin at 10 mg three times per week and the patient stayed in remission after 18 months of follow up. (Source: Australasian Journal of Dermatology)

Erosive mucosal lichen planus and secondary epiphora responding to systemic cyclosporin A treatment

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

We report the case of a woman with severe cicatrizing mucosal LP and ocular symptoms secondary to presumed nasolacrimal duct involvement. We also report the potential for this newly appreciated manifestation of LP to respond to systemic cyclosporin A. (Source: Australasian Journal of Dermatology)

Pseudoxanthoma elasticum-like lesions in association with thalassaemia major

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

A 33-year-old woman with a background of thalassaemia major presented with a 3-month history of yellowish plaques on the back of her neck bilaterally and alterations in the texture of the skin in both axillae. Examination of these lesions showed yellowish cobblestone plaques and coalescing papules in both axillae. Pseudoxanthoma elasticum (PXE)-like lesions were confirmed histopathologically. PXE-like lesions in association with thalassaemia major are an uncommon occurrence. Due to the increase in the survival rate of thalassaemia major patients on treatment, the development of these lesions is likely to increase. The histopathological manifestation of these lesions mimics that of hereditary PXE and is associated with severe vascular complications. This case highlights the importance of re...

Comparative efficacy of thalidomide and prednisolone in the treatment of moderate to severe erythema nodosum leprosum: A randomized study

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

The present study was undertaken to compare the efficacy and safety of thalidomide to that of oral prednisolone in the treatment of moderate to severe type 2 lepra reaction. Sixty patients with a histologically confirmed diagnosis of erythema nodosum leprosum with a clinical score of 4 or more (i.e. moderate to severe type 2 reaction) were randomly allocated to two groups comprising 30 patients each. Group 1 patients were given thalidomide at a dose of 300 mg/day for 1 week and the dose was gradually reduced, and Group 2 received prednisolone 40 mg daily for 2 weeks, which was tapered by 10 mg every 2 weeks. Thalidomide induced a faster clinical response (cutaneous as well as systemic) compared with prednisolone. Patients taking thalidomide had fewer relapses and a longer period of remissi...

Thoroughness of skin examination by melanoma patients: Influence of age, sex and partner

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

The aim of this study was to determine the thoroughness of deliberate skin examination by people with a history of melanoma. Patients were randomized into one of two conditions: either to receive the brief educational and skills training intervention alone or as a couple with their spouse or cohabiting partner. Subjects recorded concerning lesions on body maps. At the 4-month visit, a total body skin examination was performed by a dermatologist blinded to the subjects' condition and to their recorded responses. The skin surface was divided according to the region's visibility during skin self-examination and sexual connotations: visible/not sexually sensitive, non-visible/not sexually sensitive and sexually sensitive. The primary point of comparison was missed lesions, defined as the diffe...

Evaluation of the treatment of non-melanoma skin cancers by surgical excision

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

A retrospective study of all non-melanoma skin cancers excised by two dermatologists at a private practice in 2004 (excluding Mohs microscopic surgery cases) was conducted. Two hundred and forty-one patients were treated, with a total of 453 tumours excised. The overall incomplete excision rate was 2.2% (10/453). For basal cell cancers, the incomplete excision rate was 1.54% (5/324) and for squamous cell cancers including Bowen's disease the incomplete excision rate was 3.9% (5/129). The majority of repairs were primary closures (82.6%). Although a significant proportion of the tumours were from the head and neck region (45.9%), this study demonstrated that careful patient selection, experience of the surgeon and adherence to recommended excision margins can achieve a favourable incomplete...

Select the most correct answers – multiple answers possible for questions 1–11

Australasian Journal of Dermatology — Wed, 22 Jul 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Conditions masquerading as infantile haemangioma: Part 1

Australasian Journal of Dermatology — Fri, 24 Apr 2009 09:41:24 +0100

This article focuses on the myriad of diagnostic mimics of haemangiomas, including other vascular anomalies, benign growths, and malignancies. (Source: Australasian Journal of Dermatology)

Clinical procedures in laser skin rejuvenation

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Reflectance confocal microscopy of cutaneous tumors: an atlas with clinical, dermoscopic and histological correlations

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Tribute

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

John richard tonkin

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

In other journals

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

Subungual and periungual congenital blue naevus

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

We report a 21-year-old Hispanic woman with a slowly enlarging 1.7 × 2.3-cm subungual and periungual pigmented plaque present since birth on her right second toe. Initial biopsy was consistent with a blue naevus of the cellular type and, given the recent clinical change and periungual extension, complete excision was recommended. The entire nail unit was resected down to periosteum with prior avulsion of the nail plate. Reconstruction was performed with a full-thickness skin graft. Follow up at 1 year revealed well-healed graft and donor sites with complete return of function. We present a case of a congenital subungual and periungual blue naevus of the cellular type and review the literature on this rare presentation of a congenital blue naevus. (Source: Australasian Journal of Dermatolo...

Pyogenic granuloma complicating pulsed-dye laser therapy for cherry angioma

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

A 37 year-old-woman presented for cosmetic removal of a 7-mm (diameter) cherry angioma on her right anterior thigh. Various treatment options were discussed and removal of the lesion using pulsed-dye laser was carried out. The patient returned 5 weeks later complaining of bleeding from the treatment site, which on examination showed a 23 × 23-mm friable nodular lesion with the typical appearance of a pyogenic granuloma. This lesion was removed by shave excision, curettage and electrodessication. Histopathological examination confirmed the diagnosis of pyogenic granuloma. This is a rare occurrence post pulsed-dye laser therapy that physicians may choose to discuss with patients prior to performing this procedure. (Source: Australasian Journal of Dermatology)

Unusual presentation of GLUT-1 positive infantile haemangioma

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

Infantile haemangiomas are usually not present at birth. This is a case of a female infant with an atypical congenital vascular tumour present at birth which ulcerated in the first few days of life, involuted over several months and showed histopathological features in keeping with either an involuting GLUT-1 positive infantile haemangioma or a reticular haemangioma of infancy. The initial clinical presentation was atypical for an infantile haemangiomas and for a congenital haemangioma, however the histopathology and immunohistochemistry assisted with confirmation of the diagnosis. Vacuum-assisted closure (VAC) therapy aided in the complete healing of the ulcerated infantile haemangioma which was not achievable with conventional dressings. (Source: Australasian Journal of Dermatology)

Solitary mastocytoma occurring at a site of trauma

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

We describe a patient with a solitary mastocytoma arising at a site of trauma. The patient was born with the umbilical cord wrapped around her right thigh and subsequently developed a solitary mastocytoma in the exact site and distribution of this injury. The pathogenesis of mast cell proliferation in solitary mastocytoma is not completely understood. Cytokines released after injury, such as stem cell factor, may stimulate the proliferation of mast cells, as well as fibroblasts and melanocytes to form a mastocytoma. Mast cells in a newborn may be more sensitive to stem cell factor in the presence of cytokines released after injury due to an increased density of c-kit receptors. We present our patient and review the literature to support a hypothesis that this condition represents a reactiv...

Successful treatment of lymphomatoid papulosis with photodynamic therapy

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

A 40-year-old woman presented with a prolonged history of recurrent crops of erythematous papules and nodules on her abdomen, arms and legs. Histological examination of a cutaneous biopsy revealed Type A lymphomatoid papulosis. Over a 3-year period, some of the patient's lesions had proven to be resistant to treatment with topical and intralesional corticosteroids and systemic agents including methotrexate, tetracycline and nicotinamide. These resistant lesions were treated with two sessions of methyl aminolevulinate photodynamic therapy given 1 week apart. Review 11 months post-photodynamic therapy demonstrated complete clinical clearance at the treatment site. While photodynamic therapy is considered a standard non-surgical treatment option for non-melanoma skin cancers and has been desc...

Allergic contact dermatitis from exposure to Grevillea robusta in New Zealand

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

There are a number of reports in the literature of allergic contact dermatitis as a result of exposure to the sawdust and plant parts of Grevillea robusta. While this tree is prevalent in New Zealand, there seems to have been no previous published accounts of contact dermatitis, although anecdotal evidence indicates that such cases may be common. Two brief case reports are provided regarding severe phytodermatitis to G. robusta among professional arborists in New Zealand. As with other common plants capable of inducing allergic contact dermatitis, greater awareness among arborists, orchardists, forestry workers, gardeners, and health professionals will likely result in a reduction of cases. (Source: Australasian Journal of Dermatology)

Delayed diagnosis of Gorlin's syndrome in a renal transplant recipient

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

A 35-year-old woman was referred to the dedicated dermatology clinic for RTR. She underwent her first renal transplant at 18 years of age due to chronic renal failure following reflux nephropathy of the single right kidney (left kidney agenesis). She has since then had two further transplants. During clinical examination she was noted to have at least 16 basal cell carcinomas (BCC) and there are records in the case notes of 10 BCC having being excised and confirmed histologically in the past. By contrast, she had only had two squamous cell carcinomas (SCC) excised. She was also noted to have distinctive facial features, a kyphoscoliosis and palmar pits, and a diagnosis of Gorlin's (naevoid BCC) syndrome (GS) was made. Although immunosuppression may have contributed to the multiplicity of h...

Vulval fixed drug eruption due to paracetamol

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

We describe a case of FDE due to paracetamol presenting as a chronic erosive vulvitis in an older woman taking multiple medications. Diagnosis was delayed because paracetamol is available without prescription, taken intermittently and may be omitted from the clinical history. Cessation of paracetamol led to prompt resolution of symptoms. Consideration should be given to paracetamol as a cause of FDE presenting as a chronic erosive vulvitis. (Source: Australasian Journal of Dermatology)

Vulval and perianal inflammatory linear verrucous epidermal naevus

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

We present a case of ILVEN occurring on the vulva and perianal region of a 6-year-old girl. The lesion was initially thought to be an area of lichenified dermatitis; however, treatment with even super-potent topical corticosteroids did not significantly improve the inflammation. A biopsy was performed and histopathological examination showed characteristic features. ILVEN is frequently refractory to topical treatment and surgical excision of lesions may be an option for relief of symptoms. ILVEN occasionally presents in the inguinogenital region and in this area may, like many vulval naevi, be misdiagnosed as vulvitis, psoriasis, genital warts or sexual abuse. (Source: Australasian Journal of Dermatology)

Successful treatment of female-pattern hair loss with spironolactone in a 9-year-old girl

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

A 9-year-old prepubertal girl with female pattern hair loss treated with spironolactone 100 mg orally per day had objective improvement demonstrated by regrowth observed clinically and on comparison of pre- and post-treatment stereotactic scalp photographs taken 6 months apart. (Source: Australasian Journal of Dermatology)

Electronic e-isotretinoin prescription chart: Improving physicians' adherence to isotretinoin prescription guidelines

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

Oral isotretinoin is a highly effective treatment for refractory nodulocystic acne. However, it can be associated with serious adverse effects such as teratogenicity and hepatitis. Inadequate cumulative dosing may also result in reduced therapeutic efficacy and higher disease relapse. A preliminary audit had previously revealed a poor and inconsistent adherence to local isotretinoin prescribing guidelines by physicians. To achieve greater than 90% adherence to isotretinoin guidelines for all acne patients prescribed systemic isotretinoin at the National Skin Centre, Singapore, key areas and the reasons for non-adherence were identified. A specifically designed 'one-stop' electronic isotretinoin chart was launched within the electronic medical records (EMR) system to address important safet...

Eczema workshops reduce severity of childhood atopic eczema

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

In this study, patients attending the eczema workshop had a greater improvement in eczema severity thanpatients attending a dermatologist-led clinic, supporting collaborative models of service provision. (Source: Australasian Journal of Dermatology)

Select the most correct answers – multiple answers possible for questions 1–11

Australasian Journal of Dermatology — Wed, 22 Apr 2009 23:00:00 +0100

(Source: Australasian Journal of Dermatology)

42nd Annual Scientifi c Meeting

Australasian Journal of Dermatology — Sat, 18 Apr 2009 03:22:09 +0100

(Source: Australasian Journal of Dermatology)

Author Index 2009

Australasian Journal of Dermatology — Thu, 09 Apr 2009 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

Erratum

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

(Source: Australasian Journal of Dermatology)

Jean mason-johnson

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

(Source: Australasian Journal of Dermatology)

Dermatology, 2nd edition

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

(Source: Australasian Journal of Dermatology)

Letter to the editor

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

(Source: Australasian Journal of Dermatology)

In other journals

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

(Source: Australasian Journal of Dermatology)

A pink papule

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

(Source: Australasian Journal of Dermatology)

Primary cutaneous angioplasmocellular hyperplasia

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

is a plasmacellular infiltrate that has been reported only once previously in the literature, in a report of a case affecting two Latin American patients. In the present case, a systemically well 62-year-old Caucasian man presented with a nodule on the back of the neck. Histology showed a vascular proliferative process with an abundance of plasma cells in the stroma. There has been no recurrence of the lesion 2 years following curettage and diathermy. The clinicopathological presentation is consistent with primary cutaneous angioplasmocellular hyperplasia. (Source: Australasian Journal of Dermatology)

Giant basal cell carcinoma masquerading as an osteogenic sarcoma

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

An 88-year-old man presented to the dermatology outpatient clinic with an 11-month history of a rapidly growing mass overlying a clavicular fracture site. The lesion was 8 × 6 cm, painful, fixed to deeper structures and ulcerated. Superficial and deep biopsies yielded invasive basal cell carcinoma. Imaging demonstrated extensive soft tissue invasion into muscle, bone and potentially into the lung parenchyma. Due to complications arising from subsequent diagnostic procedures, the patient declined further invasive tests. The cutaneous lesion was treated with palliative radiotherapy. We explore the literature regarding the tumorigenic effects of peri-fracture cytokines on the biological behaviour of basal cell neoplasms. (Source: Australasian Journal of Dermatology)

Treatment of refractory pyoderma gangrenosum with intravenous immunoglobulin

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

We report a patient with pyoderma gangrenosum successfully treated with intravenous immunoglobulin. He had previously been treated for 4 years with high-dose corticosteroids and had developed insulin-dependent diabetes mellitus. Multiple corticosteroid-sparing agents had failed or were contraindicated. He developed no adverse effects from intravenous immunoglobulin, which allowed reduction of his prednisone to 3 mg/day, and his ulcer has completely healed. (Source: Australasian Journal of Dermatology)

Leukaemia cutis in a patient treated for breast cancer

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

A 47-year-old woman with a history of breast cancer presented with eruptive cutaneous nodules on the trunk and extremities. Treatment for her breast cancer had included surgery, radiation and chemotherapy with doxorubicin and cyclophosphamide. Biopsy of the skin lesions revealed leukaemia cutis, which led to the discovery of acute myelogenous leukaemia. This was felt to be primarily induced by doxorubicin. Treatment included induction chemotherapy in preparation for a bone marrow transplant, which resulted in the disappearance of the cutaneous lesions. However, the patient later succumbed to her leukaemia. (Source: Australasian Journal of Dermatology)

Azathioprine hypersensitivity presenting as a neutrophilic dermatosis in a man with ulcerative colitis

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

We report a case of a 46-year-old man with ulcerative colitis being treated with oral prednisolone and azathioprine. Two weeks after the initiation of azathioprine he presented with fever, fatigue, myalgias and arthralgias and a painful cutaneous eruption that was most marked in a sun-exposed distribution. This was accompanied by loose, non-bloody diarrhoea. Histopathological assessment of a skin biopsy supported a diagnosis of a neutrophilic dermatosis. The azathioprine was temporarily withheld and oral prednisolone was increased as it was thought that the neutrophilic dermatosis was associated with the underlying ulcerative colitis. The patient's symptoms and cutaneous eruption resolved quickly and azathioprine was re-introduced. Within 24 h, systemic symptoms returned along with a flori...

Epidermodysplasia verruciformis-like syndrome in association with systemic lupus erythematosus

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

A 43 year-old immunosuppressed woman presented with a widespread macular scaly rash, clinically and histologically consistent with epidermodysplasia verruciformis. She had no family history of epidermodysplasia verruciformis. Human papillomavirus typing was performed on both biopsied skin from clinical lesions and on plucked body hairs. The lesional skin from the arm and knee showed predominantly human papillomavirus-20 and -47 respectively. Human papillomavirus genotyping from the hair follicles revealed that human papillomavirus-20 had the highest viral load, irrespective of body site. (Source: Australasian Journal of Dermatology)

Management of imatinib-related exacerbation of psoriasis in a patient with a gastrointestinal stromal tumour

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

A 62-year-old woman with a pre-existing psoriasis was treated with oral imatinib (400 mg/day) for a metastatic gastrointestinal stromal tumour. Within 4 weeks of starting therapy, she developed a guttate psoriasis flare. The eruption markedly improved within 2 weeks following cessation of imatinib. However, it recurred when imatinib was recommenced. She has been able to continue on imatinib (400 mg/day) with low-dose oral methotrexate (12.5 mg/week) controlling the psoriasis. (Source: Australasian Journal of Dermatology)

Leprosy: Not always an easy diagnosis and often a management challenge

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

We report two cases of leprosy in southern Australia that presented to the dermatology outpatients' department within a 4-month period. The presentation of the first case was complex, making the correct diagnosis difficult. Both cases involved immigrants from South-East Asia, were classified as multi-bacillary leprosy as defined by the World Health Organization, and were commenced on the recommended multiple drug therapy. The ensuing clinical course was complicated, with both cases developing Type 1 leprosy reactions. The first case also developed the rare but serious dapsone-induced delayed hypersensitivity reaction. (Source: Australasian Journal of Dermatology)

A novel model of wound healing in the SCID mouse using a cultured human skin substitute

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

Studies of skin graft behaviour in rodent excisional wound models are limited by the dominance of wound contracture and graft sloughing as primary healing responses. To slow skin contraction, polytetrafluoroethylene (Teflon) rings were inserted into dorso-lateral full-thickness wounds in SCID mice. Cultured skin substitutes (OrCel), composed of cultured human keratinocytes and fibroblasts in a bovine collagen sponge, were implanted within the rings. Examination and histology of grafts 14 days later showed graft take in four of six recipients, with 90% epithelialization and wound contraction of 31[ndash]47%. Immunohistochemical studies, using human-specific antisera to distinguish graft from host tissues, showed that regenerated tissue was predominantly human. Staining with anticytokeratin,...

Perioperative management and the associated rate of adverse events in dermatological procedures performed by dermatologists in New Zealand

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

Dermatological surgery performed in an outpatient setting is common and generally perceived as safe, but the potential for serious adverse events does exist. Furthermore, there is a current lack of guidelines regarding preoperative and intraoperative monitoring of such patients. This is a retrospective study that involved a written questionnaire sent to current practising New Zealand dermatologists. Aspects investigated include their practice relating to preoperative assessments and intraoperative monitoring during standard dermatological procedures, and the resulting rate of adverse events. We found that most respondents performed dermatological procedures in dedicated theatres in outpatient clinics. The majority of survey respondents would screen for and optimize risk factors prior to su...

PEP005 (ingenol mebutate) gel, a novel agent for the treatment of actinic keratosis: Results of a randomized, double-blind, vehicle-controlled, multicentre, phase IIa study

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

The sap of the plant Euphorbia peplus is a traditional remedy for skin conditions, including actinic keratosis. The active constituent of the sap is ingenol mebutate (ingenol-3-angelate), formerly known as PEP005. This randomized, double-blind, vehicle-controlled, phase IIa study investigated the safety (and secondarily the efficacy) of two applications of ingenol mebutate gel in 58 patients with biopsy-confirmed actinic keratosis. Five preselected lesions were treated with ingenol mebutate gel, 0.0025%, 0.01% or 0.05%, or vehicle gel, on days 1 and 2 (Arm A) or days 1 and 8 (Arm B). There were no significant differences in tolerability or efficacy between Arms A and B. Treatment was well tolerated. The most common local skin responses were dose-related erythema, flaking/scaling/dryness an...

Select the most correct answers – multiple answers possible for questions 1–11

Australasian Journal of Dermatology — Mon, 19 Jan 2009 05:00:00 +0100

(Source: Australasian Journal of Dermatology)

The most common challenges in melanoma diagnosis and how to avoid them

Australasian Journal of Dermatology — Sat, 01 Nov 2008 04:00:00 +0100

Due to its particularly lethal nature and tendency to affect relatively young individuals, the timely diagnosis of melanoma remains of paramount importance for clinicians and their patients. Unfortunately, melanomas can mimic benign lesions that are overwhelmingly more common in the population than are melanomas, and misdiagnosis or delay in diagnosis of melanoma can occur. Misdiagnosis of melanoma serves as one of the most common causes for malpractice litigation brought against medical practitioners. In this review we describe seven clinical scenarios that represent challenges in melanoma diagnosis and discuss potential strategies for avoiding the errors that commonly give rise to those scenarios. (Source: Australasian Journal of Dermatology)

Subject Index 2008

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

Author Index 2008

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

Abstracts

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

The australasian college of dermatologists

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

Silver Medal Recipient 2008

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

Infliximab rescue of efalizumab withdrawal flare and psoriasis-precipitated depression

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

Accidental eyeball perforation by Dermojet syringe

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

Norwegian scabies in a renal transplant patient

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

Dermal vacuoles in two biopsies of psoriasis

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

Two patients presented with cutaneous lesions clinically typical of psoriasis. The first case was a 38-year-old man and the second was a 51-year-old woman. To confirm the diagnosis, 4-mm punch biopsy samples were obtained from both patients from the lesions on the knees. Histology in both cases was in favour of psoriasis and also revealed empty vacuoles in the papillary dermis, concentrated at sites of intense lymphocyte infiltration. The empty vacuoles resembled true fat cells or fat globules. They did not reveal positive immunostaining with CD34 antigen, suggesting that they were not lined by endothelial cells. Final histological diagnosis was psoriasis associated with dermal vacuolization. (Source: Australasian Journal of Dermatology)

Complex regional pain syndrome after dermatological surgery

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

We report a case of complex regional pain syndrome developing in a 57-year-old woman after minor skin surgery in the sole of her right foot. This was diagnosed and treated in its early phase with sympathetic blockade using guanethedine with complete recovery of symptoms. (Source: Australasian Journal of Dermatology)

Fatal delayed presentation of primary melanoma of the penis

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

A 60-year-old man presented with a 3-week history of lethargy, anorexia, breathlessness at rest, nausea and vomiting. He had a 5-year history of an undisclosed, enlarging, pigmented mass on his penis. He refused biopsy of this lesion. Fine-needle aspirate of an enlarged inguinal lymph node histologically confirmed a diagnosis of melanoma and widespread metastases were demonstrated by radiological imaging. The patient succumbed to disease within 8 days of diagnosis. Primary penile melanoma, albeit rare, is an important and sensitive dermatological problem, often leading to delayed presentation. (Source: Australasian Journal of Dermatology)

Prolidase deficiency: The use of topical proline for treatment of leg ulcers

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

A 41-year-old man with prolidase deficiency has had chronic leg ulcers and recurrent cellulitis for most of his life. Until recently he had been hospitalized at least annually for this and suffered significant morbidity as a result. Since commencing topical 5% proline in white soft paraffin ointment to treat the leg ulcers, there has been marked improvement in the ulcers and decreased frequency of hospitalizations for cellulitis. This lends further support to the use of topical proline in the treatment of patients with skin ulcers secondary to prolidase deficiency. (Source: Australasian Journal of Dermatology)

Multiple minute digitate hyperkeratoses associated with paraproteinaemia

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

An 87 year old woman with dementia presented with multiple digitate hyperkeratoses on her face, limbs and chest. She had a previous diagnosis of a paraproteinaemia, with a serum monoclonal band of immunoglobulin G-[kappa] and anaemia being detected. The skin biopsy of these hyperkeratotic lesions was characterized by multiple areas of orthokeratosis with immunoglobulin deposition. There was no association with hair follicles. These multiple digitate hyperkeratoses have been associated with underlying systemic disorders including malignancies. (Source: Australasian Journal of Dermatology)

Halo congenital naevus in a middle-aged patient with vitiligo

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

A case of halo congenital naevus is reported on the chest of a 56-year-old Asian woman with pre-existing vitiligo. The naevus measured 3.5 cm × 2 cm and underwent depigmentation around its periphery. Dermoscopic examination showed coarse pigment in the darker centre of the naevus and depigmentation in the surrounding halo. Light microscopy showed well-formed naevus cell nests with coarse melanin granules in the papillary dermis, and surrounding fibrosis. Melanocytes extended into reticular dermis, consistent with a congenital growth pattern. There was no evidence of malignancy. The epidermis was of normal appearance. S100 staining highlighted melanocytes in the dermis. Basal melanocytes were retained at the periphery of the naevus. Based on the clinical history and histological findings, ...

Leprosy: Recognizing red flags

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

A 28-year-old man from the Philippines presented with multiple papules and plaques symmetrically distributed on the arms and legs. This was associated with worsening paraesthesia of the hands and feet. A right common peroneal nerve decompression had been performed 2 years earlier. He was diagnosed with multibacillary leprosy on skin biopsy and subsequently treated with oral rifampicin, clofazamine and dapsone. (Source: Australasian Journal of Dermatology)

Hyperpigmentation, nail dystrophy and alopecia with generalised intestinal polyposis: Cronkhite–Canada syndrome

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

A 62-year-old Malaysian woman presented with a constellation of skin signs including alopecia, hyperpigmentation and nail dystrophy. On questioning, a history of diarrhoea, taste disturbance and weight loss was found. The onset of these changes coincided with the administration of thyroxine prescribed for a benign multinodular goitre. Hormonal investigations showed no abnormality and no underlying malignancy was found. Investigation of the diarrhoea showed a protein-losing enteropathy with generalized intestinal polyposis and non-specific histology. A diagnosis of Cronkhite[ndash]Canada syndrome was made. Treatment with prednisone and nutritional support has been partially effective. (Source: Australasian Journal of Dermatology)

Nodular granulomatous phlebitis: A phlebitic tuberculid

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

A 22-year-old woman presented with recurrent non-ulcerating skin nodules overlying the great saphenous vein on the anteromedial lower legs. Histology showed a granulomatous phlebitis, and polymerase chain reaction performed on lesional skin detected DNA specific for Mycobacterium tuberculosis. The lesions resolved with anti-tuberculous therapy. This case may be a further example of nodular granulomatous phlebitis, a phlebitic tuberculid. (Source: Australasian Journal of Dermatology)

Treatment of erosive vulvovaginal lichen planus with methotrexate

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

We report the successful treatment of severe long-standing erosive vulvovaginal lichen planus in four adult female patients using 2.5[ndash]7.5 mg of oral methotrexate once weekly in conjunction with topical clobetasol dipropionate 0.05% ointment and tacrolimus 0.03[ndash]0.10% ointment. All cases experienced improvement in symptoms and healing of lesions within 4[ndash]8 weeks. Methotrexate was well tolerated and no adverse events have been observed in any of the patients at follow up 4[ndash]6 months later. (Source: Australasian Journal of Dermatology)

Basal cell carcinoma of the vulva: A report of four cases

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

Four cases of vulval basal cell carcinoma were identified in multiparous females aged 46[ndash]78 years. Symptoms included discomfort and pruritus ranging from 6 weeks to 4 years in duration. Such symptoms occurred in the context of a pink vulval plaque. The non-specific symptoms, in the context of the particular anatomical site, led to late presentation. Subsequent treatment in all cases involved wide local excision following incisional biopsy. No recurrence has been documented after a minimum follow-up period of 12 months. (Source: Australasian Journal of Dermatology)

Annular lesions in Kawasaki disease: A cause of confusion

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

We present three cases of Kawasaki disease in which an annular eruption was the predominant cutaneous finding. The provisional diagnosis was Stevens[ndash]Johnson syndrome. However, the annular lesions were not typical of Stevens[ndash]Johnson syndrome: the lips were crusted without mucosal ulceration and the conjunctivitis was non-purulent without corneal erosions. Dermatologists are often involved in the initial assessment of this multisystem disease and should be aware of the variety of cutaneous manifestations, as rapid treatment is known to decrease morbidity and mortality. (Source: Australasian Journal of Dermatology)

Melanization in basal cell carcinomas: Microscopic characterization of clinically pigmented and non-pigmented tumours

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

Clinical and microscopic pigmentation may affect the treatment outcomes in basal cell carcinoma. However, there have not been any in-depth histopathological comparisons between clinically pigmented and non-pigmented basal cell carcinomas with regards to microscopic melanization. The aims of our study were to determine the proportion of pigmented basal cell carcinomas presenting to the National Skin Centre in Singapore, to characterize the histological pattern of melanization and to perform a semi-quantitative analysis of the degree of microscopic melanization of the tumours. Patients with clinical features and histologically confirmed basal cell carcinomas were recruited. Demographic data and clinical characteristics were recorded and basal cell carcinoma sections were examined for histolo...

Treatment of lentigo maligna with total circumferential margin control using vertical and horizontal permanent sections: A retrospective study

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

We describe the use of total circumferential margin control with vertical and horizontal permanent sections for the treatment of lentigo maligna that we believe is simple, effective and reproducible. (Source: Australasian Journal of Dermatology)

Meyerson's naevus: A clinical and histopathological study of 11 cases

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

We undertook a clinical and histopathological analysis of patients presenting with Meyerson's naevi. Eleven patients with the characteristic histological features of a Meyerson's naevus were identified over a 5-year period. Diagnostic criteria included epidermal spongiosis and a dermal inflammatory infiltrate associated with a banal junctional or compound naevus. Cases were excluded if naevus cells showed moderate to severe atypia or regression. Patients were contacted by phone and interviewed regarding their lesions. The most common clinical appearance was a solitary, pruritic, erythematous eruption encircling a pre-existing pigmented naevus. The trunk and proximal upper extremities were preferentially affected. Only one clinician listed Meyerson's naevus in the clinical differential diag...

Therapy-related leukaemia cutis: A review

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

This article reviews the factors that contribute to therapy-related leukaemia and the development of leukaemia cutis. (Source: Australasian Journal of Dermatology)

Select the most correct answers – multiple answers possible for questions 1–11

Australasian Journal of Dermatology — Mon, 06 Oct 2008 04:00:00 +0100

(Source: Australasian Journal of Dermatology)

Evaluating statistics in clinical trials: Making the unintelligible intelligible

Australasian Journal of Dermatology — Fri, 01 Aug 2008 04:00:00 +0100

Medical practitioners should be familiar with the basic principles of statistical testing and analysis, as the critical evaluation of clinical trials is an essential component to the effective practise of evidence-based medicine. Practitioners also need to be able to identify unethical trial design. The aim of this review is to facilitate an understanding of inferential methodology by introducing some of the basic principles involved in the critical analysis of trial design and interpretation. (Source: Australasian Journal of Dermatology)

Systemic therapy of paediatric atopic dermatitis: An update

Australasian Journal of Dermatology — Sun, 13 Jul 2008 06:36:16 +0100

Topical therapies are the mainstay in the treatment of atopic dermatitis, and are effective in the majority of patients with mild and localized disease. In patients with widespread or recalcitrant moderate to severe dermatitis, systemic therapies may be required. The frequently used systemic therapies are immunosuppressants, immune response modifiers, anti-inflammatories, antihistamines, and antibiotics. In this article, the indications and scientific support for the use of these medications is reviewed. (Source: Australasian Journal of Dermatology)