An enlarging nodule on the shin

Skin cancer prevention messages on Facebook: Likes, shares, and comments

Publication date: Available online 5 March 2018
Source:Journal of the American Academy of Dermatology
Author(s): Adi Nosrati, Matthew A. Pimentel, Ashley Falzone, Roshini Hegde, Shilpa Goel, Mary-Margaret Chren, Rachel Eye, Eleni Linos, Sherry Pagoto, Barbara J. Walkosz

Patient quality of life fluctuates before and after Mohs micrographic surgery: A longitudinal assessment of the patient experience

Publication date: Available online 5 March 2018
Source:Journal of the American Academy of Dermatology
Author(s): Junqian Zhang, Christopher J. Miller, Victoria O'Malley, Jeremy R. Etzkorn, Thuzar M. Shin, Joseph F. Sobanko
BackgroundChanges in patient perceptions of quality of life (QOL) after Mohs micrographic surgery (MMS) may benefit from different counseling or treatment.ObjectiveTo measure QOL before and after MMS and to identify risk factors associated with impaired QOL.MethodsProspective observational study of 727 skin cancer patients who self-reported QOL via the Skin Cancer Index immediately before and at 1-2 weeks and 3 months after MMS.ResultsQOL fluctuated after MMS. At 1-2 weeks after surgery, overall QOL remained unchanged compared to before MMS. Patients reported reduced anxiety about skin cancer, but had increased distress about social interactions and physical appearance. At three months after surgery, patients reported an overall improvement in QOL compared to before MMS, (p = 0.0007). Age under 65 years (p = 0.0001), female gender (p = 0.0001), and tobacco use (p = 0.03) were associated with lower QOL scores at all assessment points.LimitationsSingle-site observational study. Significant loss to follow-up at both time points after MMS.ConclusionSkin cancer patients had persistent concerns about social interactions and physical appearance 1-2 weeks after MMS, but all aspects of QOL improved by three months after surgery. MMS patients who were less than 65 years old, female, or smoked were at increased risk for longitudinally impaired QOL.

Teaser

Patient QOL is initially impaired from restricted social interactions and appearance concerns after Mohs micrographic surgery (MMS), but QOL improves from baseline by three months after MMS. Patients younger than 65, women, and smokers report worse QOL before and after MMS, Characterizing the evolution of and risk factors for impaired QOL may allow targeted management to improve the experience of MMS patients.

Type I pityriasis rubra pilaris treated with tumor necrosis factor inhibitors, ustekinumab, or secukinumab: a systematic review

Publication date: Available online 5 March 2018
Source:Journal of the American Academy of Dermatology
Author(s): Nolan J. Maloney, Lisa D. Hisaw, Scott Worswick

An Effective Game-Based Learning Intervention for Improving Melanoma Recognition

Publication date: Available online 5 March 2018
Source:Journal of the American Academy of Dermatology
Author(s): Amit Sharma, Muneeb Ilyas, Nishita Maganty, Nan Zhang, Mark R. Pittelkow

Assessing the Safety of Superficial Chemical Peels in Darker Skin: A Retrospective Study

Publication date: Available online 5 March 2018
Source:Journal of the American Academy of Dermatology
Author(s): Shalini Vemula, Mayra B.C. Maymone, Eric A. Secemsky, Raphael Widjajahakim, Nicole M. Patzelt, Dana Saade, Neelam A. Vashi
BackgroundChemical peels have shown efficacy in the treatment of acne, photoaging, and pigmentary dyschromias; however, studies evaluating side effects, particularly in patients with skin of color, are limited.ObjectiveWe sought to determine the frequency of side effects and complications associated with superficial chemical peels in patients with skin types III-VI.MethodsA 5-year single center retrospective analysis was performed.ResultsOf 473 chemical peel treatments included in this study, 18 (3.8%) were associated with short-term (≤2 weeks) or long-term (>2 weeks) complications. The most frequent complications were crusting (2.3%), post-inflammatory hyperpigmentation (PIH) (1.9%) and erythema (1.9%). All side effects resolved within 8 months of treatment and were located on the face. When stratified by season, side effects were noted to be less common during the winter. In the adjusted model, Fitzpatrick skin type VI was associated with a higher odds of side effects (OR, 5.14; 95% [CI], 1.21-21.8; P=0.0118).LimitationsSingle center retrospective design.ConclusionIn this study, superficial chemical peels performed in patients with skin types III-VI had a relatively low complication rate, and skin type VI had higher odds of experiencing an adverse event. Side effects were noted to be less frequent during the winter months.

Teaser

There is limited data about the side effects and complications of chemical peels in darker skin types. Side effects are infrequent and include post-inflammatory erythema, crust, and post-inflammatory hyperpigmentation with no permanent sequelae. When performed in an appropriate manner, superficial chemical peels have a relatively low complication rate in darker skin types.

Somatic and psychiatric comorbidities of hidradenitis suppurativa in children and adolescents.

Publication date: Available online 5 March 2018
Source:Journal of the American Academy of Dermatology
Author(s): Hannu Tiri, Jari Jokelainen, Markku Timonen, Kaisa Tasanen, Laura Huilaja
BackgroundHidradenitis suppurativa (HS) is associated with various somatic and psychiatric comorbidities. Data regarding comorbidities in young HS patients are sparse.ObjectiveWe analyzed both somatic and psychiatric comorbidities in young patients in a nationwide HS cohort.MethodsIn this retrospective case-control study, data from cases of HS in young (aged ≥5 and <18 years) patients and age-matched controls with benign melanocytic nevi were collected from the Finnish Care Registry of Health Care. The prevalence of preselected comorbidities was compared between HS and control groups.ResultsA total of 153 HS cases were found in the specified age group. Of these, 34.0% had one or more somatic comorbidity compared with 4.9% of controls. At least one of the preselected psychiatric diagnoses was present before the age of 18 years in 15.7% of HS cases compared with 5.6% of controls. By the age of 23 years, at least one psychiatric comorbidity was identified in 23.5% of HS patients and 8.7% of controls.LimitationsDespite being one of the largest HS cohorts ever studied, the number of young HS patients was relatively low. Since this was a registry-based study, it was not possible to verify the accuracy of International Classification of Diseases codes.ConclusionPhysicians should monitor young patients with HS for both somatic and psychiatric comorbidities.

Teaser

- Epidemiologic data on hidradenitis suppurativa in childhood and adolescence are sparse; - This study demonstrates the psychiatric and somatic comorbidities of hidradenitis suppurativa in young patients; - Young patients with hidradenitis suppurativa need care for the comorbidities of HS, which may accumulate over time.

The Prognostic Significance of Tumor-Infiltrating Lymphocytes for Primary Melanoma Varies by Sex

Publication date: Available online 5 March 2018
Source:Journal of the American Academy of Dermatology
Author(s): Andrew J. Sinnamon, Cimarron E. Sharon, Yun Song, Madalyn G. Neuwirth, David E. Elder, Xiaowei Xu, Emily Y. Chu, Michael E. Ming, Douglas L. Fraker, Phyllis A. Gimotty, Giorgos C. Karakousis
BackgroundThe immune response to melanoma is manifested locally by tumor-infiltrating lymphocytes (TILs). Men and women are known to have varying patterns of immunity, yet sex-specific prognostic implications of TILs have not been explored.MethodsPatients with clinically localized primary melanoma ≥0.76mm in Breslow thickness who underwent sentinel lymph node (SLN) biopsy at our institution were identified. Association between TILs (absent, nonbrisk, and brisk) and SLN positivity was evaluated using logistic regression. Overall survival (OS) was evaluated by TILs status and sex.ResultsAmong 1,367 patients identified, 794 were men. TILs were brisk in 143 lesions, nonbrisk in 903, and absent in 321, which did not vary by sex (p=0.71). SLN positivity was associated with TILs among men (brisk 3.8%, nonbrisk 16.9%, absent 26.6%, p<0.001). In contrast, there was no association between SLN positivity and TILs among women (p=0.49). Interaction between brisk TILs and sex on SLN positivity was significant (p=0.029). Among men, presence of brisk TILs was associated with prolonged OS (p=0.038) but not after adjustment for SLN status (p=0.42). There was no association between TILs status and OS among women.LimitationsFindings from this single-institution study have yet to be validated by other research groups.ConclusionsThe implications of TILs in predicting SLN positivity appear to be more relevant for men than women.

Teaser

Some studies suggest tumor-infiltrating lymphocytes in primary melanoma are associated with a lower likelihood of sentinel lymph node mestastases. In this institutional cohort study, TILs were found to be predictive of SLN status in men but not among women. TILs status may be more useful for clinical decision-making among men than women

Characterizing the environmental impact of metals in construction and demolition waste

Abstract

Large quantities of construction and demolition (C&D) waste are generated in China every year, but their potential environmental impacts on the surrounding areas are rarely assessed. This study focuses on metals contained in C&D waste, characterizing the metal concentrations and their related environmental risks. C&D waste samples were collected in Shenzhen City, China, from building demolition sites, renovation areas undergoing refurbishment, landfill sites, and recycling companies (all located in Shenzhen city) that produce recycled aggregate, in order to identify pollution levels of the metals As, Cd, Cr, Cu, Pb, Ni, and Zn. The results showed that (1) the metal concentrations in most demolition and renovation waste samples were below the soil environmental quality standard for agricultural purposes (SQ-Agr.) in China; (2) Cd, Cu, and Zn led to relatively higher environmental risks than other metals, especially for Zn (DM5 tile sample, 360 mg/kg; R4 tile sample, 281 mg/kg); (3) non-inert C&D waste such as wall insulation and foamed plastic had high concentrations of As and Cd, so that these materials required special attention for sound waste management; and (4) C&D waste collected from landfill sites had higher concentrations of Cd and Cu than did waste collected from demolition and refurbishment sites.

Rapid and high-capacity adsorption of PFOS and PFOA by regenerable ammoniated magnetic particle

Abstract

Adsorption is well accepted as an effective method for perfluorinated compounds' (PFCs) removal from water among various conventional methods. However, development of adsorbents that combine good performance of PFC removal and regenerability has not yet been realized. This work demonstrated the fabrication and application of an ammoniated magnetic adsorbent for efficient and economical PFOS and PFOA removal. Functional ammonium groups and γ-Fe₂O₃ were effectively incorporated in the particle with the proposed method. These fabricated magnetic particles presented superior adsorption performance for PFOS and PFOA with short equilibrium time of 120 min and high adsorption capacity. The isotherms revealed that the adsorption process belonged to multilayer sorption with their intricate interactions including anion exchange and hydrophobic interaction. The magnetic particle maintained its removal efficacy over a wide pH range of 3–9 or with coexisting substances. Moreover, the regeneration and reuse of the magnetic particle were successfully carried out with PFOS and PFOA removal efficiency sustained higher than 80% in 15 consecutive treatment cycles. Along with the efficient adsorption and easy separation of adsorbents, we expect that this ammoniated magnetic particle can serve as an excellent alternative for PFOS and PFOA removal from water.

Enhanced sterilization and healing of cutaneous pseudomonas infection using 5-aminolevulinic acid as a photosensitizer with 410-nm LED light

After the discovery of penicillin by Fleming in 1929, various antibiotics have been discovered and developed, making it one of the most important medical interventions to reduce morbidity and mortality [1,2]. However, multi-resistant bacteria have emerged due to the misuse of antibiotics [3], and we are challenged by this new threat. Thus, new means for treating infections that do not rely on antibiotics are needed.

Skin cancer prevention messages on Facebook: Likes, shares, and comments

Assessing the Safety of Superficial Chemical Peels in Darker Skin: A Retrospective Study

There is limited data about the side effects and complications of chemical peels in darker skin types. Side effects are infrequent and include post-inflammatory erythema, crust, and post-inflammatory hyperpigmentation with no permanent sequelae. When performed in an appropriate manner, superficial chemical peels have a relatively low complication rate in darker skin types.

Somatic and psychiatric comorbidities of hidradenitis suppurativa in children and adolescents.

- Epidemiologic data on hidradenitis suppurativa in childhood and adolescence are sparse; - This study demonstrates the psychiatric and somatic comorbidities of hidradenitis suppurativa in young patients; - Young patients with hidradenitis suppurativa need care for the comorbidities of HS, which may accumulate over time.

Patient quality of life fluctuates before and after Mohs micrographic surgery: A longitudinal assessment of the patient experience

Patient QOL is initially impaired from restricted social interactions and appearance concerns after Mohs micrographic surgery (MMS), but QOL improves from baseline by three months after MMS. Patients younger than 65, women, and smokers report worse QOL before and after MMS, Characterizing the evolution of and risk factors for impaired QOL may allow targeted management to improve the experience of MMS patients.

The Prognostic Significance of Tumor-Infiltrating Lymphocytes for Primary Melanoma Varies by Sex

Some studies suggest tumor-infiltrating lymphocytes in primary melanoma are associated with a lower likelihood of sentinel lymph node mestastases. In this institutional cohort study, TILs were found to be predictive of SLN status in men but not among women. TILs status may be more useful for clinical decision-making among men than women

An Effective Game-Based Learning Intervention for Improving Melanoma Recognition

Type I pityriasis rubra pilaris treated with tumor necrosis factor inhibitors, ustekinumab, or secukinumab: a systematic review

Have reducing tonsillectomy rates in England led to increasing incidence of invasive Group A Streptococcus infections in children?

Abstract

Objectives

To determine if there is a correlation between falling tonsillectomy numbers and increasing numbers of tonsillitis admissions and invasive Group A β-haemolytic streptococcus (iGAS) infection in children aged 14 and under in England.

Design

An observational cross-sectional study was performed.

Setting

The data extracted covered the period from 1991 until 2014.

Participants

Hospital admissions for tonsillectomies, tonsillitis/pharyngitis, and and all diagnoses of iGAS in children aged 14 and under who had a tonsillectomy.

Main outcome measures

Correlation between trends in tonsillectomies, tonsillitis/pharyngitis and iGAS.

Results

Across all age groups there was a dramatic reduction in the total number of tonsillectomies performed in England from 28,309 in 1990/1991, down to 6327 in 2013/2014 (77.7% reduction). The numbers of hospital admissions for management of acute tonsillitis and pharyngitis has risen dramatically. iGAS numbers have increased steadily over this time period and more than doubled in children aged 14 and under. There are significant negative correlations between the trend in iGAS infections and numbers of tonsillectomies in all ages. There are also strong positive correlations between the trend in numbers of tonsillitis episodes and the number of iGAS infections in all under14 year groups; the strongest correlation was seen in the 1-4 years age group (+0.92 Pearson correlation coefficient).

Conclusions

There appears to be a correlation between falling tonsillectomy numbers, increasing hospital admissions with tonsillitis and rising iGAS infection in England. Further studies are required to assess the aetiological role of tonsillitis in predisposing to iGAS infection and the potential societal benefit of tonsillectomies.

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Assessment of n -pentanol/ Calophyllum inophyllum /diesel blends on the performance, emission, and combustion characteristics of a constant-speed variable compression ratio direct injection diesel engine

Abstract

Alcohol is used as an additive for a long time with the petroleum-based fuels. In this study, the higher alcohol, n-pentanol, was used as an additive to Calophyllum inophyllum (CI) biodiesel/diesel blends at 10, 15, and 20% by volume. In all blends, the ratio of CI was maintained at 20% by volume. The engine characteristics of the pentanol fuel blends were compared with the diesel and CI20 (Calophyllum inophyllum 20% and diesel 80%) biodiesel blend. The nitrogen oxide (NO) emission of the pentanol fuel blends showed an increased value than CI20 and neat diesel fuel. The carbon dioxide (CO₂) also increased with increase in pentanol addition with the fuel blends than CI20 fuel blend and diesel. The carbon monoxide (CO) and hydrocarbon (HC) emissions were decreased with increase in pentanol proportion in the blend than the CI20 fuel and diesel. The smoke emission was reduced and the combustion characteristics of the engine were also improved by using pentanol blended fuels. From this investigation, it is suggested that 20% pentanol addition with the biodiesel/diesel fuel is suitable for improved performance and combustion characteristics of a diesel engine without any engine modifications, whereas CO₂ and NO emissions increased with addition of pentanol due to effective combustion.