Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Nov 2010
Review Case ReportsCutaneous collagenous vasculopathy with generalized telangiectasia in two female patients.
Cutaneous collagenous vasculopathy is characterized by generalized cutaneous telangiectasia and unique microscopic and ultrastructural vascular changes, consisting of marked collagen deposition within the vascular walls of the post-capillary venules in the superficial dermis. There are only 4 previous cases described in the medical literature, all in males, mostly middle-aged. We have recently seen two female patients with clinical and histopathologic features diagnostic of cutaneous collagenous vasculopathy, indicating that it is not restricted to males. As cutaneous collagenous vasculopathy can be clinically indistinguishable from generalized essential telangiectasia, and histopathologic studies are rarely performed for this condition, it is likely that cutaneous collagenous vasculopathy frequently passes unrecognized, but it may be more common than previously thought.
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J. Am. Acad. Dermatol. · Oct 2010
Review Meta AnalysisSilver treatments and silver-impregnated dressings for the healing of leg wounds and ulcers: a systematic review and meta-analysis.
Previous systematic reviews of silver-impregnated dressings have been contradictory regarding the healing of leg wounds/ulcers. Our systematic review was restricted to randomized controlled trials. Cochrane Library, Scopus, and MEDLINE databases were searched using the term "silver" in combination with "wound" or "ulcer" (and plural versions) without date/language restriction. ⋯ Meta-analyses found strong evidence for wound healing based on wound size reduction but no evidence based on complete wound-healing or healing rates. Although our results provide some evidence that silver-impregnated dressings improve the short-term healing of wounds and ulcers, long-term effects remain unclear. Clinical trial data with longer follow-up times are needed to address these issues.
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J. Am. Acad. Dermatol. · Apr 2010
ReviewSystematic review of the safety of topical corticosteroids in pregnancy.
Pregnant women may have skin conditions that require topical corticosteroids. However, little is known about their safety in pregnancy. ⋯ Currently limited and inconclusive data are unable to detect an association between topical corticosteroids and congenital abnormality, preterm delivery, or stillbirth. The current evidence shows no statistically significant difference between pregnant women who use and those who do not use topical corticosteroids. However, there does appear to be an association of very potent topical corticosteroids with low birthweight. Further cohort studies with comprehensive outcome measures, consideration of corticosteroid potency, dosage and indications, and a large sample size are needed.
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J. Am. Acad. Dermatol. · Jan 2010
ReviewCaterpillars and moths: Part II. Dermatologic manifestations of encounters with Lepidoptera.
Caterpillars and moths (order Lepidoptera) are uncommonly recognized causes of adverse cutaneous reactions, such as localized stings, papular dermatitis, and urticarial wheals. These reactions are typically mild and self-limited; however, in South America, the sting of Lonomia caterpillars can cause a potentially fatal hemorrhagic diathesis related to massive fibrinolysis. ⋯ Therapies for mucocutaneous reactions to Lepidoptera are largely empiric, with the exception of antivenin against Lonomia obliqua envenomation. Part II of this two-part series on caterpillars and moths reviews the varied symptoms caused by Lepidopteran exposures, reviews the differential diagnosis, and discusses appropriate treatment algorithms.
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J. Am. Acad. Dermatol. · Jan 2010
ReviewCaterpillars and moths: Part I. Dermatologic manifestations of encounters with Lepidoptera.
Caterpillars are the larval forms of moths and butterflies and belong to the order Lepidoptera. Caterpillars, and occasionally moths, have evolved defense mechanisms, including irritating hairs, spines, venoms, and toxins that may cause human disease. The pathologic mechanisms underlying reactions to Lepidoptera are poorly understood. ⋯ It also reviews the known pathomechanisms of disease caused by Lepidopteran exposures and how they relate to diagnosis and management. Part II discusses the specific clinical patterns caused by Lepidopteran exposures, with particular emphasis on groups of caterpillars and moths that cause a similar pattern of disease. It also discusses current therapeutic options regarding each pattern of disease.