Dermatology online journal
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Dermatol. Online J. · Aug 2003
Case ReportsPeculiar pattern of nail pigmentation following cyclophosphamide therapy.
Cyclophosphamide is one of several cancer chemotherapy agents that can cause nail hyperpigmentation. We report a patient who began to have an unusual form of nail pigmentation after 8 months of receiving monthly pulses of dexamethasone-cyclophosphamide. The patient developed nail pigmentation that started proximally and spread distally but involved only the nails of the thumb, index finger, and half the middle finger of both hands.
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Cutaneous larva migrans is a tropical disease that typically is acquired on exposed surfaces in patients who have been sitting or lying on moist ground or other surfaces which have been contaminated by dog or cat feces. A patient is reported who presented with typical, severely pruritic, migratory plaques after sleeping on a wet, bus station floor.
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Psoriasis is a complex disorder that negatively impacts quality of life. Treatment strategies must address both psychosocial and physical aspects of the disease. Psoriasis can be categorized into localized and generalized forms for treatment purposes. ⋯ For patients unresponsive to phototherapy or who are not able to come on a regular basis, methotrexate is an effective alternative. Cyclosporine is useful, especially for short-term use in settings of acute exacerbation, but should be replaced by other modalities for long-term maintenance. Other agents that have a place in treatment of generalized psoriasis include hydroxyurea and mycophenolate mofetil.
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Dermatol. Online J. · Nov 1999
Case ReportsThe clinical diagnosis of early malignant melanoma: expansion of the ABCD criteria to improve diagnostic sensitivity.
With the steady increase in incidence of malignant melanomas (MM) in the United States, early diagnosis and complete removal are critical for the containment of the malignancy. [1] The "ABCD" method of identification, originally described by Friedman et al., has been a useful tool in facilitating the diagnosis of MM. [2,3,4] This method analyzes four clinical characteristics to identify a malignant melanoma: Asymmetry, Border irregularity, Color variegation, and a Diameter of 6 mm or more.[4] Clinicians recognize that some melanomas lack all or most of the features defined in the "ABCD" rules. [5] This may be especially true of some early invasive and in situ melanomas. [6,7] In these instances, clinical history documenting morphologic change over time can be an important additional consideration. The following case reports underscore the need to expand the ABCD mnemonic to include an "E" for "Evolutionary change." An additional modification is also needed to emphasize the need for a low threshold for biopsy of unusual lesions which do not show typical benign features, even if they do not meet the ABCDE criteria. To this end we propose an "F" for "Funny looking lesions".