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Cellfina observations: pearls and pitfalls.
Authors: Green JB, Cohen JL Abstract In our experience, patients tend to consider any undesirable feature on their body from the knees to the umbilicus, and even the arms, to be cellulite. It is important to educate prospective patients that Cellfina (Uithera, Inc, Mesa, Arizona) most effectively treats dimple-type cellulite, whereby fibrous bands inserting into the undersurface of the skin cause a puckered appearance. In this brief communication, we would like to share our experience in optimizing outcomes with Cellfina for the treatment of cellulite. PMID: 26682337 [PubMed - in process] (Source: ...
Source: Seminars in Cutaneous Medicine and Surgery - December 20, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Introduction.
Authors: Cohen JL, Green JB PMID: 26682338 [PubMed - in process] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - December 20, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Introduction.
Authors: Goldberg LJ PMID: 26682339 [PubMed - in process] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - December 20, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

White lesions in the oral cavity: clinical presentation, diagnosis, and treatment.
Authors: Jones KB, Jordan R Abstract White lesions in the oral cavity are common and have multiple etiologies, some of which are also associated with dermatological disease. While most intraoral white lesions are benign, some are premalignant and/or malignant at the time of clinical presentation, making it extremely important to accurately identify and appropriately manage these lesions. Due to their similar clinical appearances, it may be difficult sometimes to differentiate benign white lesions from their premalignant/malignant counterparts. This review will discuss many of the most common intraoral whit...
Source: Seminars in Cutaneous Medicine and Surgery - December 11, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Differential diagnosis and management of oral ulcers.
Authors: Siu A, Landon K, Ramos DM Abstract The diagnosis and treatment of oral lesions is often challenging due to the clinician's limited exposure to the conditions that may cause the lesions and their similar appearances. While many oral ulcers are the result of chronic trauma, some may indicate an underlying systemic condition such as a gastrointestinal dysfunction, malignancy, immunologic abnormality, or cutaneous disease. Correctly establishing a definitive diagnosis is of major importance to clinicians who manage patients with oral mucosal disease. Some of these diseases are infectious; however, mos...
Source: Seminars in Cutaneous Medicine and Surgery - December 11, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

HPV and oropharyngeal cancer: etiology and prognostic importance.
Authors: Yom SS Abstract HPV is the most common sexually transmitted disease, but the overwhelming majority of individuals clear the infection. A small percentage of individuals develop persistence of oncogenic HPV types, especially HPV-16; and as a result, squamous cell carcinoma can develop in the tonsils and base of the tongue. Over 70% of oropharyngeal cancers are now thought to be associated with oncogenic HPV infection. Immunohistochemistry for p16 protein is often used as a surrogate marker for oncogenic HPV in the oropharyngeal tissues, although alternative HPV DNA testing methods are under intensi...
Source: Seminars in Cutaneous Medicine and Surgery - December 11, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Genital lichen planus: update on diagnosis and treatment.
Authors: Zendell K Abstract Lichen planus (LP) is an inflammatory autoimmune disease that affects both glabrous and mucosal skin. Although pathophysiology has not yet been fully defined, LP is a T-cell mediated disorder that demonstrates an increased Th1 cytokine expression as well as T-cell reactivity against basement membrane zone components. In males, genital LP often takes its more classic form as pink, shiny, flat-topped papules on the glans and coronal sulcus. In women, erosive disease is most common and often leads to significant scarring and sexual dysfunction. Therapeutic management is challenging...
Source: Seminars in Cutaneous Medicine and Surgery - December 11, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Noninfectious genital ulcers.
Authors: Kirshen C, Edwards L Abstract Noninfectious genital ulcers are much more common than ulcers arising from infections. Still, it is important to take a thorough history of sexual activity and a sexual abuse screen. A physical exam should include skin, oral mucosa, nails, hair, vulva, and vaginal mucosa if needed. The differential diagnosis of noninfectious genital ulcers includes: lipschütz ulcers, complex aphthosis, Behçet's syndrome, vulvar metastatic Crohn's disease, hidradenitis suppurativa, pyoderma gangrenosum, pressure ulcers, and malignancies. It is important to come to the correct diagnos...
Source: Seminars in Cutaneous Medicine and Surgery - December 11, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Vulvodynia.
Authors: Ben-Aroya Z, Edwards L Abstract Vulvodynia is a pain syndrome affecting the vulva. It occurs in about 16% of women at some time of their lives. The etiology of vulvodynia is still enigmatic and is probably multifactorial-including physiological concerns (eg, pelvic floor muscle dysfunction, neuropathic pain, and psychosocial) and sexual issues (eg, anxiety and sexual dysfunction). Although it is a common syndrome, most patients are neither correctly diagnosed nor treated. A diagnosis of vulvodynia is based upon patient history and lack of physical findings upon careful examination. No clinical or ...
Source: Seminars in Cutaneous Medicine and Surgery - December 11, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Epithelial vulvar neoplasms and their changing classification.
Authors: Ball R, Ball KM, Reutter J Abstract In recent years, there have been many changes in the classification scheme for squamous lesions of the vulva; this is primarily due to the assimilation of new scientific information into the diagnostic terminology. For example, over the past 75 years we have realized that precancerous and cancerous lesions of the vulva may be induced by a variety of preconditions, which are typically divided into human papillomavirus (HPV) and non-HPV precursor lesions. The latter include several dermatoses, especially lichen sclerosus and lichen planus. Additionally, we have le...
Source: Seminars in Cutaneous Medicine and Surgery - December 11, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Understanding Onychomycosis Treatment: Mechanisms of Action and Formulation.
Authors: Jellinek NJ Abstract Historically, the eradication of onychomycosis has been a frustrating and often unsuccessful endeavor. However, new understanding about the mechanisms of action of antifungal agents, the introduction of two new topical agents, and the drugs and devices now being investigated offer greatly improved options for current and future management of these infections. The mechanisms of action of systemic and topical antifungal agents and devices effective against the most common dermatophyte and nondermatophyte causes of onychomycosis are discussed. Semin Cutan Med Surg 34(supp3):S51-S...
Source: Seminars in Cutaneous Medicine and Surgery - December 5, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Update on New and Emerging Therapies in the Management of Psoriasis.
Authors: Gordon KB Abstract Tumor necrosis factor inhibitors are a mainstay of treatment for patients with psoriasis who require systemic therapy. Since the approval of several of these agents, other biologic agents and small molecules have been developed; some of these have been approved recently by the US Food and Drug Administration, and others have shown great promise in clinical trials. The currently available and emerging treatments for psoriasis offer clinicians and patients an expanded list of options for individualizing treatment, potentially resulting in higher levels of improvement in both the d...
Source: Seminars in Cutaneous Medicine and Surgery - December 5, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Management Strategies for Onychomycosis in Special Patient Populations.
Authors: Rich P Abstract Clinicians must be aware of characteristics unique to certain populations when diagnosing and treating onychomycosis. For example, although onychomycosis is uncommon in children, it should be considered in the differential diagnosis when young patients have nail changes, particularly if a family history of onychomycosis is present. In elderly patients, comorbid medical conditions may complicate systemic treatment, and physical impairments may interfere with topical therapy. Nondermatophyte molds and yeasts should be considered as possible pathogens in patients with diabetes and pso...
Source: Seminars in Cutaneous Medicine and Surgery - December 5, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Understanding and Reducing the Risk for Acne Scarring.
Authors: Leyden JJ Abstract Scarring is a lifelong, physically disfiguring and often emotionally debilitating sequela resulting from acne vulgaris. Nearly 80% of patients have some scarring and 50% have clinically relevant scarring. Although the extent, duration, and intensity of inflammation are important risk factors, scarring also can develop in patients with relatively mild inflammation. Assessment of scarring should be part of the evaluation in all patients with acne and should be a consideration in determining treatment. Semin Cutan Med Surg 34(supp5):S89-S91 © 2015 published by Frontline Medical Co...
Source: Seminars in Cutaneous Medicine and Surgery - December 5, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Making Strides in Preventing Onychomycosis Recurrence.
Authors: Young MS Abstract Onychomycosis is a clinically important infection that is frequently progressive and may be associated with clinical sequelae. Accurate diagnosis, appropriate choice of antifungal agent-with consideration given to particular patient characteristics, including the presence of concomitant diseases and ability to comply with a given regimen-careful follow-up, and consideration of long-term management and reinfection prevention strategies are crucial to successful treatment. Semin Cutan Med Surg 34(supp3):S56-S58 © 2015 published by Frontline Medical Communications. PMID: 26...
Source: Seminars in Cutaneous Medicine and Surgery - December 5, 2015 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research