0
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 50.19.47.197. Please contact the publisher to request reinstatement.
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. 2014;150(8):799. doi:10.1001/jamadermatol.2013.6550.
Text Size: A A A
Published online

RESEARCH

The most important risk factors for melanoma include a predisposing genetic mutation, a history of melanoma, and multiple atypical nevi. The efficacy of various diagnostic screening interventions among these high-risk patients remains uncertain. In this prospective observational study, Moloney et al demonstrate that baseline total body imaging and sequential digital dermoscopy imaging were effective in diagnosing melanoma early in this extreme-risk population. Hypervigilance for difficult-to-detect thick melanoma subtypes was also considered crucial.

Regression in melanoma is defined as an area within the tumor in which neoplastic cells have disappeared or become reduced in number from the dermis and have been substituted by fibrosis. The influence of regression on melanoma prognosis remains a matter of controversy. In this retrospective study of melanomas thicker than 0.75 mm, Botella-Estrada et al demonstrate that regression did not show a statistically significant association with sentinel lymph node status. These data do not support the practice of sentinel lymph node biopsy in thin melanomas with regression in the absence of additional adverse prognostic characteristics.

Sagging eyelids, or dermatochalasis, are a frequent concern among older adults. Other than intrinsic skin aging, risk factors contributing to this condition remain unclear. In this observational study, Jacobs et al demonstrate that the nongenetic risk factors of age, male sex, lighter skin color, higher BMI, and smoking increased the risk of dermatochalasis. A high degree of heritability was also detected, and the C allele of rs11876749 on chromosome 18 showed some genome-wide protective effect for sagging eyelid severity.

Acne scarring has been associated with significant psychological consequences, yet effective treatment remains a challenge. Fractional resurfacing laser treatment to induce neocollagenesis has been used successfully. Needle rollers, which use a macroscopic approach to induce small epidermal and dermal perforations, have been reported to induce neocollagenesis and improve acne scarring. In this split-face randomized clinical trial, Alam et al demonstrate that there was improvement in the appearance of acne scars after 3 needling treatments, with minimal pain reported. Needling may offer benefits to patients with acne scarring without access to laser treatments or in combination with fractional laser treatments.

Methotrexate is frequently used in the management of long-term severe psoriasis. Liver fibrosis remains the main disadvantage of treatment, and monitoring of liver enzyme and procollagen III peptide levels has been recommended during therapy. Liver biopsy is the standard for diagnosing liver fibrosis, but the procedure is associated with significant morbidity and mortality. In this cohort study, Lynch et al demonstrate that transient elastography using pulse-echo ultrasonography and FibroTest (an indirect measure of hepatic fibrosis) were effective noninvasive tools for monitoring hepatotoxic effects in patients receiving methotrexate. The need for liver biopsy could be reduced if abnormalities in these tests were required before biopsy is considered.

Figures

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.

1,262 Views
0 Citations
×

Related Content

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

Jobs