Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Apr 2013
ReviewGeriatric dermatology: Part I. Geriatric pharmacology for the dermatologist.
Issues related to prescribing dermatologic drugs in the elderly are less recognized than age-related skin findings. This is related in part to the lack of a standardized residency training curriculum in geriatric dermatology. ⋯ These changes include volume of distribution, renal function, liver toxicity from interactions of commonly prescribed drugs, and medications that can decompensate cognition in the older patient population. We outline seven prescribing principles related to older dermatology patients, including useful strategies to reduce polypharmacy and improve drug adherence, using an evidence-based approach whenever possible.
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J. Am. Acad. Dermatol. · Sep 2012
ReviewTropical dermatology: Venomous arthropods and human skin: Part II. Diplopoda, Chilopoda, and Arachnida.
Members of arthropod classes Chilopoda (centipedes), Diplopoda (millipedes), and Arachnida (spiders and scorpions) cause tissue injury via bites, stings, and/or a release of toxins. A few members of the Acari subclass of Arachnida (mites and ticks) can transmit a variety of infectious diseases, but this review will cover the noninfectious manifestations of these vectors. Dermatologists should be familiar with the injuries caused by these arthropods in order to initiate proper treatment and recommend effective preventative measures.
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DRESS (drug rash with eosinophilia and systemic symptoms), also known as drug-induced hypersensitivity syndrome, is a severe, systemic drug reaction most commonly associated with aromatic anticonvulsants and sulfonamides. Patients typically present with fever, facial edema, cervical lymphadenopathy and a morbilliform eruption, which may progress to erythroderma. Hematologic abnormalities are a hallmark of the condition, including eosinophilia and atypical lymphocytosis. ⋯ Myocarditis is a fatal and under-recognized manifestation of DRESS, which may occur long after the initial diagnosis. We review the literature of previously reported cases of DRESS and myocardial involvement, highlighting the presenting symptoms associated with cardiac involvement, treatments used, and the outcome for each patient. In addition, we offer an algorithm for early diagnosis, treatment, and subsequent monitoring of these patients.
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J. Am. Acad. Dermatol. · May 2012
ReviewSarcoidosis: a comprehensive review and update for the dermatologist: part I. Cutaneous disease.
Sarcoidosis is a common systemic, noncaseating granulomatous disease of unknown etiology. The development of sarcoidosis has been associated with a number of environmental factors and genes. ⋯ Numerous therapeutic options are available for the treatment of cutaneous sarcoidosis, but there are few well designed trials to guide practitioners on evidence-based, best practice management. In part I, we review the current knowledge and advances in the epidemiology, etiology, pathogenesis, and genetics of sarcoidosis, discuss the heterogeneous manifestations of cutaneous sarcoidosis, and provide a guide for treatment of cutaneous sarcoidosis.