Disclaimer: While every attempt is made to ensure that drug dosages provided within the text of this journal and the website are accurate, readers are urged to check drug package inserts before prescribing. Views and opinions in this publication and the website are not necessarily endorsed by or reflective of those of the publisher.
Ear Lesions That Recur Every Spring
Members of the College of Family Physicians of Canada may claim one non-certified credit per hour for this non-certified educational program.
Francesca Cheung, MD CCFP, is a family physician with a special interest in dermatology. She received the Diploma in Practical Dermatology from the Department of Dermatology at Cardiff University in Wales, UK. She is practising at the Lynde Centre for Dermatology in Markham, Ontario and works closely with Dr. Charles Lynde, MD FRCPC, an experienced dermatologist. In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne.
Abstract
Juvenile spring eruption is a photodermatosis that is considered a localized variant of polymorphic light eruption. This condition appears on the light exposed areas of the ears and is primarily found in boys and young males in early spring or summer. The exact pathogenesis of juvenile spring eruption is not clear. The symptoms usually clear within 2 weeks, but recurrences are common under similar climatic conditions. The diagnosis of juvenile spring eruption is made clinically and investigations are not required. Treatments include avoidance of sun exposure, emollients, potent topical corticosteroids, and antihistamines. Keywords: juvenile spring eruption, photodermatosis, polymorphic light eruption, spring, ears.
Francesca Cheung, MD CCFP, is a family physician with a special interest in dermatology. She received the Diploma in Practical Dermatology from the Department of Dermatology at Cardiff University in Wales, UK. She is practising at the Lynde Centre for Dermatology in Markham, Ontario and works closely with Dr. Charles Lynde, MD FRCPC, an experienced dermatologist. In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne.
Abstract Cutaneous larva migrans is a parasitic infection caused by percutaneous penetration and subsequent migration of the larvae of hookworm. The tracks are commonly raised, erythematous, serpiginous, and pruritic. Cutaneous larva migrans is diagnosed based on its clinical characteristics. It is a self-limiting condition because larvae eventually die in humans without being able to infest new hosts. Treatment is used to shorten the disease course, control the intense pruritus, and prevent the risk of secondary infection. Topical thiabendazole is the treatment of choice for mild and localized condition. Systemic treatment such as albendazole, mebendazole, and ivermectin are used in widespread cases or cases recalcitrant to topical treatment. Keywords: cutaneous larva migrans, parasitic infection, hookworm, Ancylostoma braziliense, thiabendazole.
Francesca Cheung, MD CCFP, is a family physician with a special interest in dermatology. She received the Diploma in Practical Dermatology from the Department of Dermatology at Cardiff University in Wales, UK. She is practising at the Lynde Centre for Dermatology in Markham, Ontario and works closely with Dr. Charles Lynde, MD FRCPC, an experienced dermatologist. In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne.
Abstract Granuloma annulare (GA) is a benign and usually self-limited cutaneous condition that classically presents as arciform to annular plaques in a symmetrical and acral distribution. The exact etiology of GA is unknown. Two-thirds of patients with GA are less than 30 years old. GA is recognized based on its characteristic appearance and no specific investigation is necessary. Reassurance and clinical observation may be the treatment of choice for localized and asymptomatic disease. Spontaneous resolution occurs within 2 years in 50% of cases. Persistent lesions may be treated with very potent topical corticosteroids, intralesional corticosteroid injections, or cryotherapy. Use of more toxic treatments are controversial in recalcitrant cases. Keywords: Granuloma annulare, Overview, Paraneoplastic, Self-limiting, Treatment.
Charles Lynde, MD, FRCPC
Editor-in-Chief for the Dermatology Educational Resource @HealthPlexus and the Journal of Current Clinical Care.
Following on the footsteps of the recent announcement of the launch of the Dermatology Educational Resource, www.HealthPlexus.net recently interviewed Dr. Charles Lynde who was appointed as Editor-in-Chief for the newly re-focused educational channel. Dr. Barry Goldlist asked Dr. Lynde a few questions about the format and the plans for this project.
Skin is the body’s largest organ. It acts as a protective layer between the insides and the rest of the world, helps regulate body temperature, acts as a natural filter and is constantly growing. It’s affected by every aspect of our life, by what we eat and the environment. Skin that is healthy is able to resist signs of aging, heals faster and can even stave off potential disease. It often manifests some underlying diseases and when it’s visually altered or damaged can make a profound effect on one’ quality of life.
As the newly appointed Editor-in-Chief for the Dermatology Educational Resource @HealthPlexus and the Journal of Current Clinical Care and with the help of my fellow editors Drs. Anne Goodfellow, John Kraft, and Francesca Cheung, we will solicit, organize and present to you educational materials of relevance to primary care practitioners and specialists alike by asking for contributions from recognized Key Opinion Leaders in the field of Dermatology on evidence-based best practices and treatment options.
In this issue, we are featuring the first article in our dermatology section titled Common Lumps and Bumps in Children: A Colour-coded Differential. Dr. Joseph Lam and Shahana Nathwani examine the many conditions that present as ‘lumps and bumps’ in the pediatric population. While some follow a benign course, others require definitive therapy or carry the potential for serious complications. Their review presents and categorizes common pediatric cutaneous lesions according to colours as a tool to help the general practitioner recognize and remember these lesions.
If you have questions, interested in serving as a contributor or peer-reviewer please reach out to us at contactus@healthplexus.net
I hope you enjoy this issue of the Journal. Feedback and discussion, as always, is welcomed.
The 81st Annual Meeting of the Canadian Dermatology Association was held June 27 - July 2, 2006 in Winnipeg, Manitoba.
Issues and Advances in Acne Management: A Special Report from the Annual Meeting of the Canadian Dermatology Association.
Dr Neil Shear, MD; John Wolf, MD; Richard Thomas, MD
Please note that the online, video portions of this report require the most recent version of Adobe Flash Player, which can be obtained as a free download by clicking here.
This multi-media conference report was made possible by an unrestricted educational grant from Galderma Canada Inc.
Shahana Nathwani, BHK, Faculty of Medicine, University of British Columbia, Vancouver, BC. Joseph M Lam, MD, FRCP(C), Clinical Assistant Professor, Department of Pediatrics, Associate Member, Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, BC.
Abstract Many conditions present as 'lumps and bumps' in the pediatric population. Some follow a benign course and can be safely observed with parental education and reassurance. Others require definitive therapy or carry the potential for serious complications. Understanding and recognizing the different lesions will help guide the care, counseling and management of patients with these common 'lumps and bumps'. This review presents and categorizes common pediatric cutaneous lesions according to colours as a tool to help the general practitioner recognize and remember these lesions. Keywords: benign; pediatric; tumours; vascular; hemangioma; nevus.
A 27-year-old MSM, presented to care with a rash. The rash appeared several weeks prior to presentation and involved the face, chest and back, arms and legs and was not accompanied by pruritus. He denied fever, chills, but complained of fatigue. No respiratory, gastrointestinal or urinary symptoms were present. He disclosed a diagnosis of HIV infection a year earlier, but has not kept his follow up appointments and was not receiving anti-retroviral medications or opportunistic infection prophylaxis. His most recent CD4 count was 109/mm3. He admitted sexual encounters with several male partners with inconsistent condom usage, and recalled a penile lesion that was present several weeks before the rash had appeared. The lesion has healed without specific therapy.
On physical examination: in no apparent distress, vital signs were within normal limits.
Notable finding on the examination included multiple small and non-tender anterior cervical, posterior cervical, axillary and inguinal lymph nodes. Genital examination revealed a healed lesion on the glans penis. A macular skin rash was widely distributed over face, trunk and extremities with several lesions on palms and soles (figure 1. and 2.)
1. What is your diagnosis?
2. Would you obtain a lumbar puncture?
Publication of THE LATEST IN ACNE CARE supplement was made possible by an unrestricted educational grant from Galderma Canada Inc.
Maha Theresa Dutil, MD, M.Ed, FRCPC, Assistant Professor of Medicine, Division of Dermatology, University of Toronto, Toronto, ON.
One of the marked changes in the practice of dermatology over the past thirty years has been the increased focus on acne. What was once considered a universal rite of passage that occasionally caused deeply disturbing scars is now considered—by patients and doctors alike—an insufferable condition that must be treated. Perhaps as a sign that available treatments are increasingly successful, acne is showing signs of affecting popular culture. Kid Acne, a British artist (not his real name!), decided to make his affliction his signature so as to stand out in the crowded hip-hop scene. The Uruguayan movie Acné (as you would have guessed, about a thirteen-year-old boy coming of age while enduring acne outbreaks) was a hit of Spanish-speaking cinema in 2008. Acne for Dummies by Dr. Herbert P. Goodheart (a remarkably good book!) ranks a respectable 76th in skin care/ beauty books on Amazon.ca.
Success has bred the desire for even more success. This supplemental publication to Dermatology Times on "Innovations in Acne Care: The Latest Guidelines and Treatment Options" sheds light on new approaches that will be helpful to specialists and GPs alike. Dr. Neil Shear's "Newest Guidelines for the Treatment of Acne" discusses the acne guidelines...
Professor and Chief of Dermatology, Professor of Medicine, Pediatrics and Pharmacology, University of Toronto Faculty of Medicine; Head of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON.
Abstract: This article summarizes key statements from the 2009 Global Alliance to Improve Outcomes in Acne Group's therapeutic guidelines, published as a supplement in the Journal of the American Academy of Dermatology (JAAD). It offers an algorithm for acne treatment, as well as addresses important statements from the committee on acne pathophysiology, epidemiology, and the latest research findings, as they pertain to the guidelines.
Dermatologists should be actively contributing to educating other clinicians that acne is a chronic disease.
Despite many extensive educational programs, the committee sees an ongoing need to urgently reduce the use of antimicrobial therapies, especially as single agents.
A combination of a topical retinoid plus an antimicrobial agent is first-line therapy for most patients with acne (a finding based on clinical trials with over 16,000 total subject participants in studies of Level I evidence quality), as it targets multiple pathogenic features and both inflammatory and noninflammatory acne lesions.
The Global Alliance 2009 update affirms that topical retinoids should be fundamentally a core component of an acne therapy regimen for stages I to III. The committee's consensus is that early and appropriate treatment, continued for as long as necessary, is the best approach to mitigating scarring for acne patients.
Implement strategies to improve adherence to therapy (e.g., medication reminders, self-monitoring with diaries, support groups, telephone follow-up) to ensure success.
Treat acne as quickly and as efficiently as possible to achieve the best therapeutic outcomes, and to improve patient satisfaction, limit treatment expenses, and mitigate scarring.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
One of the marked changes in the practice of dermatology over the past thirty years has been the increased focus on acne. What was once considered a universal rite of passage that occasionally caused deeply disturbing scars is now considered—by patients and doctors alike—an insufferable condition that must be treated. Perhaps as a sign that available treatments are increasingly successful, acne is showing signs of affecting popular culture. Kid Acne, a British artist (not his real name!), decided to make his affliction his signature so as to stand out in the crowded hip-hop scene. The Uruguayan movie Acné (as you would have guessed, about a thirteen-year-old boy coming of age while enduring acne outbreaks) was a hit of Spanish-speaking cinema in 2008. Acne for Dummies by Dr. Herbert P. Goodheart (a remarkably good book!) ranks a respectable 76th in skin care/ beauty books on Amazon.ca.
