0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA Dermatology |

Highlights FREE

JAMA Dermatol. 2013;149(9):1011. doi:10.1001/jamadermatol.2013.4083.
Text Size: A A A
Published online

RESEARCH

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions affecting the skin and mucous membranes for which the primary identifiable cause is medication use. Carbamazepine is the most common cause of SJS and TEN. A relationship between HLA genes and carbamazepine-induced SJS and TEN has been described, specifically the HLA-B*1502 allele. In this systematic review and meta-analysis, Tangamornsuksan et al confirm this strong relationship among Chinese, Thai, and Malaysian patients and suggest that recognizing HLA-B allele status before initiating drug therapy may be beneficial. These data support the US Food and Drug Administration’s recommendations for screening for the HLA-B*1502 allele before initiating carbamazepine therapy in patients of Asian ancestry.

Psoriasis is a chronic, debilitating inflammatory disease associated with impairment of the innate and adaptive immune system. The cytokine network is responsible for initiation, maintenance, and recurrence of skin lesions. Biological agents have emerged as effective treatments for psoriasis, exerting their pharmacologic effects through their variable portion (which blocks the target molecule) and their constant portion (which binds to Fcγ receptors, or FcγRs). In this retrospective case series, Julià et al demonstrate that FcγR polymorphisms play a role in the outcome of anti–tumor necrosis factor treatment of psoriasis. These data may help dermatologists by guiding therapeutic decisions, especially where quick therapeutic responses are needed.

Cutaneous sarcoidosis is one of the most common extrapulmonary manifestations of sarcoidosis, and it is often resistant to treatment. A growing body of literature supports the immunomodulatory effects of antimicrobial therapy, and case reports demonstrate improvement of cutaneous sarcoidosis lesions with tetracycline treatment. Because of the possible association between sarcoidosis and mycobacterial antigens, Drake et al hypothesize that broad-spectrum antimycobacterial therapy could lead to improvements in cutaneous sarcoidosis. This randomized, placebo-controlled trial demonstrates that an oral regimen of levofloxacin, ethambutol, azithromycin, and rifampin resulted in significant reductions in cutaneous sarcoidosis lesions.

Debridement is the process of removing necrotic tissue, bacteria, and foreign material from chronic wound beds to facilitate wound healing. Debridement techniques include autolytic, enzymatic, mechanical, surgical, and biosurgical methods. Although wound debridement is widely used, limited research on its efficacy has been conducted. In this retrospective cohort study, Wilcox et al demonstrate that a higher frequency of debridement improves healing outcomes and that wounds with longer intervals between debridements (>2 weeks) healed more slowly.

ARTICLE INFORMATION

Section Editor: Robin L. Travers, MD.

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

984 Views
0 Citations
×

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs