Skin and Connective Tissue Diseases Commons^™

Inadequate Sensitivity Of Laboratory Risk Indicator To Rule Out Necrotizing Fasciitis In The Emergency Department, Elizabeth Burner, Sean Henderson, Guenevere Burke, Jeffrey Nakashioya, Jerome R. Hoffman

Emergency Medicine Faculty Publications

Introduction: Necrotizing fasciitis (NF) is a life-threatening illness, particularly when surgical debridement is delayed. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was developed to identify patients at higher risk for NF. Despite limited information in this regard, the LRINEC score is often used to "rule out" NF if negative. We describe the sensitivity of the LRINEC score in emergency department (ED) patients for the diagnosis of NF.

Methods: We conducted a chart review of ED patients in whom coding of hospital discharge diagnoses included NF. We employed standard methods to minimize bias. We used laboratory data to …

Pain In Photodynamic Therapy, Mircea Tampa, Maria Isabela Sârbu, Mădălina Irina Mitran, Cristina Iulia Mitran, Adrian Dumitru, Vasile Benea, Simona Roxana Georgescu

Journal of Mind and Medical Sciences

Photodynamic therapy is a modern treatment with applications in several medical specialties, which has been intensely studied in the last years. The main indications in dermatology are actinic keratosis, superficial basal cell carcinoma and Bowen's disease- common skin disorders in which photodynamic therapy proved its efficacy. At present, the use of photodynamic therapy for the treatment of other skin disorders is profoundly researched. Pain is the most common and redoubtable adverse effect of photodynamic therapy and it is the most important factor affecting the patient's adherence to treatment. The aim of this article is to look over the most recent …

Stinging Nettle: The Bad, The Good, The Unknown, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Stinging nettle (Urtica dioica) is native to most of the United States. It has a characteristic description and distribution in the environment. Physical contact with numerous tiny needlelike hairs present on leaves and stems of this plant may result in a contact urticarial dermatitis due to chemical and mechanical irritation triggered by skin penetration of the hairs. The manifestations are self-limited in humans and may be treated by washing the skin, topical preparations and oral antihistamines. Explanation of the natural history of these encounters to the patient is helpful in reducing the sometimes significant anxiety. Preparations and extracts …

Phage Therapy As A Mrsa Treatment, Miriam Sussman

The Science Journal of the Lander College of Arts and Sciences

This paper seeks to review how previous research on bacteriophage therapy can be utilized to improve the treatment of MRSA infections. Due to the growing phenomenon of antibiotic resistance, scientists are looking to utilize the natural antibacterial qualities of bacterial viruses called phages to fight MRSA infections. In order to improve the therapeutic methods of combatting MRSA, one must first understand the mechanics of how phages infect bacterial cells and lyse them with their proteins. The narrow host range of bacteriophages causes the infection of only the pathogenic bacteria and maintains the state of the normal flora. Research suggests that …

Treatment Options For Skin And Soft Tissue Infections Caused By Methicillin-Resistant Staphylococcus Aureus, Renee Weinberg

The Science Journal of the Lander College of Arts and Sciences

Staphylococcus aureus is a pathogen responsible for common skin infections, such as impetigo, cellulitis, folliculitis, and abscess and it is the most common cause for skin and soft tissue infections (SSTI). Humans are carriers of this microorganism and are responsible for facilitating its spread around the world. Over time it has developed resistance to multiple antibiotics, such as penicillin and methicillin, which has made S. aureus a persistent problem in the healthcare world today. Its methicillin resistance has given it the more commonly known name methicillin-resistant S. aureus (MRSA). MRSA was initially discovered solely in the healthcare environment and thus …

Medical Interns', Residents' And Attending Physicians' Attitudes Towards Integrative Medicine And Recommended Treatments For Patients With Psoriasis, Jennifer L. Pacyon

PCOM Psychology Dissertations

Background: Psoriasis is a multifactorial disease that effect approximately 7.5 million Americans. There are a variety of traditional treatments for psoriasis (e.g. topical medications, biologics) that for many, are effective in combating the disease. However, traditional treatments often have aversive side effects and may not be appropriate for every patient (e.g. pregnant women). Additionally, the efficacy of these medications are variable leaving some looking for adjunctive treatment options. There is increasing evidence to support the use of adjunctive treatments for psoriatic patients (e.g. psychotherapy, mindfulness). However, research is variable in regards to medical professionals’ attitudes towards integrative medicine (IM) as …

Is Narrowband Uvb Phototherapy In Combination With Nonsteroidal Topical Medications More Effective At Repigmentation Of Vitiligo Lesions When Compared To Narrowband Uvb Therapy Alone In Healthy Men And Women Between The Ages Of 11 And 69?, Cassandra Baier

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not narrowband UVB (NB-UVB) phototherapy in combination with nonsteroidal topical medications is more effective at repigmentation of vitiligo lesions when compared to NB-UVB therapy alone in healthy men and women between the ages of 11 and 69.

STUDY DESIGN: Review of three peer-reviewed randomized controlled trials written in English, two of which were published in 2014, and one in 2011.

DATA SOURCES: Studies were selected based on the method of study, the randomized- control structure of the studies, and the relevance to the clinical question, and all …

Lavender Oil: The New Sleep Aid, Audrey Nichols

University Honors Program

The purpose of this research paper is to discuss and evaluate the benefits of lavender oil within the general population and hospitalized patients. Specifically, this paper will look at aromatherapy use with lavender oil within the hospitalized population and it’s ability to better sleep quality within these patients. Sleep is a major factor in the boies ability to heal, and the hope of this research is to determine whether lavender oil would be an effective option for patients struggling with sleep disturbances during their hospital stay. In order to evaluate the effectiveness of lavender oil, previously conducted research articles and …

Basal Cell Carcinoma—A Preventable Disease, Jamie Weaver

Nursing Student Class Projects (Formerly MSN)

Basal cell carcinoma (BCC) is a nonmelanoma skin cancer. According to the Skin Cancer Foundation, “BCC is the most frequently occurring form of all skin cancers. More than one out of every three new cancers is a skin cancer, and the vast majority are BCC’s” (www.skincancer.org). Exposure to ultraviolet (UV) rays is one of the main risk factors in developing a BCC. People with a lighter skin tone are at a higher risk of developing a BCC than those with a darker skin tone.

Gout, Lorrie Listebarger

Nursing Student Class Projects (Formerly MSN)

Gout is a syndrome caused by an inflammatory response creating an over production of uric acid increasing uric acid levels in the blood and body fluids. Gout is defined as a disorder resulting from tissue deposition of MSU crystals (in joints, bursae, bone, and certain other soft tissues, such as ligaments, tendons and occasionally, skin) and/or crystallization of uric acid within the renal collecting system (tubules and renal pelvis) that typically occurs in acid urine” (Terkeltaub & Edwards, 2013, p. 20). Gout is among the oldest diseases affecting approximately 3.9% of adults in America (Terkeltaub & Edwards, 2013, p. xv). …

Dermatitis Herpetiformis, Rachel Wolf

Nursing Student Class Projects (Formerly MSN)

The main sign that accompanies DH is the eruption of intensely pruritic papulovesical lesions that typically present bilaterally on the elbows, knees, buttocks, neck, and scalp (Criado et al., 2012). They may appear on the upper back, abdomen, groin, and face as well. The lesions are small blisters that resemble those that are caused by the herpes simplex virus. By the time a patient seeks evaluation by a care provider, the lesions have often been scratched so much as to cause erosions, excoriation, and or crusted papules (Junkins-Hopkins, 2010). The surrounding area may have erythema and or urticarial plaques. Patients …

Functional Analysis Of The Molluscum Contagiosum Virus Mc160 Death Effector Domain-Containing Protein Rxdl Motif, Sarah Weber

Seton Hall University Dissertations and Theses (ETDs)

The Molluscum contagiosum virus (MCV) is a member of the Poxviridae family that causes benign skin lesions. MCV lesions persist on average for 8-12 months in otherwise healthy individuals. MCV lesions are characterized by reduced inflammation. The persistence and reduction of inflammation at the site of MCV lesions have been attributed to MCV immune evasion genes. MCV encodes two death effector domain (DED) containing proteins, MC159 and MC160. DEDs are found in cellular proteins such as FADD and procaspase-8. These cellular proteins are involved in several innate immune responses such as apoptosis and activation of interferon (IFN). Presumably, MC159 and …

Is Benzoyl Peroxide And Clindamycin Effective Combination Treatment For Progressive Macular Hypomelanosis In Adults?, Samantha Colosi

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not there is efficacy with combination treatment benzoyl peroxide and clindamycin for progressive macular hypomelanosis in adults.

Study Design: A review of three English language studies. One published in 2006 and two in 2011. Includes two RCT’s and one randomized left-right comparison study.

Data Sources: Researched articles via PubMed and Cochrane database. All articles were published in peer-reviewed journals. Two randomized, controlled trials and one randomized left-right comparison study were used.

Outcomes Measured: The outcomes measured by: subjective patient ratings based on photographs before and after treatment …

Is Prophylactic Oxybutynin Safe And Effective In Reducing The Severity Of Palmar Hyperhidrosis In Adults?, Kristin K. Amicone

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine “Is prophylactic oxybutynin safe and effective in reducing the severity of palmar hyperhidrosis in adults?”

STUDY DESIGN: This review is based on two randomized controlled trials (RCTs) and one non-randomized crossover study published in 2008, 2011, and 2012. The studies compared the safety and efficacy of oxybutynin in reducing the severity of palmar hyperhidrosis.

DATA SOURCES: All articles used were published in English, in peer-reviewed journals, and found using PubMed, Ebscohost, and Cochrane Review databases.

OUTCOMES MEASURED: For all studies, the safety and effectiveness of oxybutynin on palmer hyperhidrosis …

Is A Once Daily Topical Application Of Fixed-Dose Combination Gel Containing Adapalene 0.1%-Benzoyl Peroxide (Bpo) 2.5%(Adapalene-Bpo) Effective At Treating Mild To Moderate Acne?, Kelly A. Weitzel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not a once daily topical application of fixed-dose combination gel containing adapalene 0.1%-benzoyl peroxide (BPO) 2.5% (adapalene-BPO) is effective at treating mild to moderate acne.

STUDY DESIGN: Three multi-center double blind randomized control studies published in the English language between 2007-2013.

STUDY SOURCES: Three peer-reviewed RCTS were found using Pubmed. These studies compared the same fixed-dose combination gel adapalene-BPO against placebo vehicles. Two studies also compared to additional groups receiving monotherapies.

OUTCOMES MEASURED: Outcomes measured were improvement of participant’s acne according to the Investigator’s Global Assessment of …

Necrotizing Fasciitis, Holly Herron

Nursing Student Class Projects (Formerly MSN)

Necrotizing fasciitis also known as necrotizing soft tissue infections (NSTIs) is a rare life-threatening infection that involves the skin and soft tissue. A rapid and accurate diagnosis of NSTIs must be identified by healthcare providers to diminish morbidity and mortality. NSTIs are characterized by progressive necrosis of subcutaneous tissue and fascia involving large areas of tissue (Lin, Chang, Lai, Lin, & Chen, 2013). Hippocrates (500 BC) described necrotizing fasciitis as “diffuse erysipelas caused by trivial accidents [where] flesh, sinews, and bones fell away in large quantities, [leading to] death in many cases” (Lancerotto, Tocco, Salmaso, Vindigni & Bassetto, 2012). In …

Steven-Johnson’S Syndrome/Toxic Epidermal Necrolysis, Lindsey Grant

Nursing Student Class Projects (Formerly MSN)

Steven-Johnson’s Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are both diseases mediated by hypersensitive immune reactions resulting in “full thickness epidermal necrosis” characterized by skin detachment. However, in SJS, there is only 10% skin surface area involvement whereas in TEN, over 30% of the skin becomes detached. TENS has a 50% mortality rate. (East-Innis & Thompson, 2013, p. 590) Why Chosen: SJS/TEN is a rare but extremely fatal disease. Initially, it is often mistaken as a simple allergic reaction to a new medication or environmental exposure because both cause truncal rashes and fevers. However, simple allergic reactions occur within days …

New Malignancies After Squamous Cell Carcinoma And Melanomas: A Population-Based Study From Norway, Trude E. Robsahm, Margaret R. Karagas, Judy R. Rees, Astri Syse

Dartmouth Scholarship

Skin cancer survivors experience an increased risk for subsequent malignancies but the associated risk factors are poorly understood. This study examined the risk of a new primary cancer following an initial skin cancer and assessed risk factors associated with second primary cancers.

Systematic Condition In A Ncaa-I Collegiate Soccer Player, Ashley D. Smith

Theses, Dissertations and Capstones

Objective: The purpose of this case study is to inform athletic trainers of a systematic disease not common in our patient population.

Background: The athlete, a twenty-one YO, 160 lb, 69 inch female NCAA-I collegiate soccer goalie presented with complaint of bilateral elbow and knee joint pain and stiffness along with tender red itchy bumps on the anterior aspect of her shins. The athlete had flu-like symptoms and a URI prior to this complaint. The athlete has a history of anemia, mononucleosis, and streptococcal.

Differential Diagnosis: Rheumatoid arthritis, lymphoma, HIV/aids, erythema nodosum, lupus, Lyme disease.

Treatment: The athlete sought out …

The Role Of Poly N Acetyl Glucosamine Nanofibers In Cutaneous Wound Healing, Amanda Haley Buff-Lindner

MUSC Theses and Dissertations

Treatment of cutaneous wounds with poly-N-acetyl-glucosamine nanofibers (pGlcNAc), a novel polysaccharide material derived from a marine diatom, results in increases in wound closure, antibacterial activities and innate immune responses. Treatment with nanofibers results in increased defensin, small antimicrobial peptides, expression both in vitro and in vivo. Induction of defensing expression results in bacterial clearance in a cutaneous wound model. We have also shown that Akt1 plays a central role in the regulation of these activities. We show that pGlcNAc treatment of cutaneous wounds in mice results in decreased scar sizes. Additionally, treatment of cutaneous wounds with pGlcNAc results in increased …