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ABSTRACT: Three open-label, uncontrolled studies have documented successful treatment of warts with cimetidine, whereas two placebo-controlled, double-blind studies and two open-label comparative trials have failed to demonstrate efficacy. This double-blind, placebo-controlled study was designed with stringent enrollment and outcome criteria to minimize the confounding issue of spontaneous remission. Efficacy was not statistically superior to that of placebo, but a trend toward efficacy was suggested for younger subjects.
Journal of the American Academy of Dermatology 08/1999; 41(1):123-7. · 3.99 Impact Factor
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ABSTRACT: The administration of a local anesthetic is often painful.
The purpose of this study was to determine whether rapidly shaking and pinching the skin during local anesthetic administration decreases pain perception.
The skin at the intended site of lidocaine injection was rapidly pinched between the thumb and forefinger just before the injection. Control patients received no intervention. Patients reported their pain perception using a visual analog scale (0 to 10). In the feasibility phase, patients were assigned to receive the pinching technique or no intervention, then randomized in the second phase.
In phase 1, 34 patients received 42 excisions. Pain was significantly reduced (p=0.001) in the treatment group. In phase 2, 69 patients had 91 excisions. When adjusted for age and sex (data combined from phases 1 and 2), the treatment significantly reduced pain (p=0.03) when compared with no intervention.
We describe a simple, noninvasive technique that significantly lowered perceived pain during the administration of unbuffered lidocaine with epinephrine local anesthetic.
Journal of the American Academy of Dermatology 08/1998; 39(1):74-8. · 3.99 Impact Factor
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Archives of Dermatology 02/1998; 134(1):99, 102. · 3.89 Impact Factor
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ABSTRACT: Traumatic tattoos result from accidental deposition of pigmented particles in the dermis. Battery-operated devices should be added to the list of situations in which traumatic tattoos may arise. In this case, an iron-containing tattoo was removed by Mohs' micrographic surgery with an acceptable cosmetic result.
Cutis; cutaneous medicine for the practitioner 02/1998; 61(1):34-6. · 0.81 Impact Factor
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Archives of Dermatology 06/1997; 133(5):651, 654. · 3.89 Impact Factor
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ABSTRACT: Basal cell carcinoma (BCC) is the most common malignant tumor of the eyelid and periocular tissues but rarely involves the lacrimal system. In addition, BCC in this location frequently recur due to inadequate margin control. A further understanding of the pathophysiology of periocular BCC was addressed.
To report two rare cases of BCC involving the lacrimal system and to account for subtle clinical features yet extensive tissue spread of periocular BCC.
Using the Mohs micrographic surgical technique, we describe two patients with a BCC involving the lacrimal system that histologically tracked beyond clinically apparent margins.
Spread of BCC along mucosal surfaces is documented.
Rare involvement of the lacrimal system by a BCC is reported in two patients. Superficial histologic involvement can explain the ability of BCC to extend locally and escape adequate treatment.
Dermatologic Surgery 04/1997; 23(3):203-6. · 1.80 Impact Factor
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ABSTRACT: Piezogenic pedal papules are small, occasionally painful, fat herniations that become apparent when weight is placed on the heel. Although the cause is unknown, hereditary factors may play a role. This is the second report of two family members with this condition.
Cutis; cutaneous medicine for the practitioner 05/1996; 57(4):260-2. · 0.81 Impact Factor
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ABSTRACT: Three patients, one healthy and two immunocompromised, developed cutaneous reactions that histologically mimicked granuloma annulare at sites of resolved varicella-zoster virus (VZV) reactivation infections. Variable latency periods between the infection and the granulomatous reaction were noted. As in other case reports, the presence of VZV DNA in these lesions was inconsistently demonstrated by the polymerase chain reaction (PCR) and appears more common in early, as opposed to late, post-zoster granulomas. In addition to various granulomatous reactions, vasculitic and neoplastic eruptions following resolved VZV infections have been described and are reviewed here. Therapeutically, topical, intralesional and systemic corticosteroids, as well as acyclovir, have been tried with inconsistent results. Although the pathogenesis remains unclear, the presence of VZV DNA in early lesions that histologically do not display viral cytopathic changes, suggests the virus induces an atypical delayed hypersensitivity reaction not affected by antiviral therapy.
British Journal of Dermatology 04/1996; 134(3):504-9. · 3.67 Impact Factor
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ABSTRACT: Candida albicans is a frequent pathogen of the female genital tract, especially during pregnancy. Congenital candidiasis can occur as cutaneous or disseminated infection. We report a case of congenital cutaneous candidiasis, which may occur more frequently than is indicated by the literature. This is followed by a discussion of the pathogenesis, clinical presentation, diagnosis, and treatment of this infection.
Pediatric Dermatology 01/1996; 12(4):359-63. · 1.07 Impact Factor
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ABSTRACT: Eruption of lymphocyte recovery (ELR) develops in the setting of leukocyte reconstitution after iatrogenic marrow aplasia and displays a superficial perivascular lymphocytic infiltrate composed of CD3+/CD4+ cells. Epidermal changes are usually minimal to absent. We report a case of an ELR mimicking mycosis fungoides with the formation of CD4+ Pautrier-like microabscesses.
Journal of Cutaneous Pathology 11/1995; 22(5):472-5. · 1.56 Impact Factor
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Journal of the American Academy of Dermatology 08/1995; 33(1):126-9. · 3.99 Impact Factor
