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Therapeutic Strategies in Dermatology

Melanoma: Treatment

…; 1 mm with aggressive features such as ulceration or mitotic index >1 per mm2) should be considered for more extensive baseline evaluation such as sentinel lymph node biopsy and/or searching for metastases (CT or MRI of the brain, chest, abdomen…

Therapeutic Strategies in Dermatology

Erythema Annulare Centrifugum: Overview

…iated with a glucagon-secreting tumor. Treatment First Steps Search for an underlying cause, specifically tinea pedis or cruris. A complete physical examination is required, especially if tinea is not found, to rule out an underlying malignancy. If…

Therapeutic Strategies in Dermatology

Melanoma: Key Points

…rimarily tumor thickness, ulceration, regression, and mitotic index), by the location of the tumor, by the presence of regional or distant metastases and by the patient characteristics (age, medical co-morbidities). Increased tumor thickness is assoc…

Therapeutic Strategies in Dermatology

Melanoma: Clinical Cases

…ickness, Clark’s level II. No ulceration present, and mitotic index <1 per mm2 She is diagnosed with Stage 1a melanoma Follow-up The patient goes for wide local excision with 1 cm margins; there is no residual melanoma in the excision specimen…

Therapeutic Strategies in Dermatology

Erythema Multiforme: Treatment

…should entail consideration of a skin biopsy and a reasonable search for potential triggers that can be eliminated or treated. Diagnostic considerations include: viral direct fluorescence antibody (DFA) testing, viral culture, herpes serologies, myco…

Therapeutic Strategies in Dermatology

Venous Stasis: Treatment

…lic blood pressure in the leg versus. the arm (ankle-brachial index, or ABI) is recommended in all patients, as standard methods for healing venous ulcerations may be ineffective in the presence of significant arterial disease. (Arterial insufficienc…

Therapeutic Strategies in Dermatology

Facial Melanosis, Melasma: References

…ty assessment and validation of the Melasma Area and Severity Index (MASI) and a new modified MASI scoring method, JAAD, 64: 78-83. Ortonne JP (2006) Retinoid therapy of pigmentary disorders, Derm Therapy, 19: 280-288. Rendon et al (2006) Treatment o…

Therapeutic Strategies in Dermatology

Livedo Vasculitis/Livedo Reticularis/Atrophie Blanche: Overview

…cquired defect in fibrinolysis making them hypercoagulable. A search for such defects should be undertaken as well as anticardiolipin antibodies, cryoglobulins, and cryofibrinogens. Underlying cancer may enhance this hypercoagulable tendency. Histolo…

Therapeutic Strategies in Dermatology

Xerosis: Overview

…bove intensive protocol does not bring relief in 2-3 weeks, a search for an underlying metabolic or neoplastic cause should be instituted. Antihistamines may be helpful adjuncts to the management of itch, but should be used with caution in the elderl…

Therapeutic Strategies in Dermatology

Cheilitis Granulomatosa: Overview

…kg/day) for 2-3 weeks, then taper the dose. Subsequent Steps Search for underlying dental or sinus inflammation. The treatment of these hidden foci of infection may lead to improvement of the cheilitis. Crohn’s disease may present as a granulo…

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