Keloid and hypertrophic scars remain a challenging condition, with potential cosmetic and functional consequences to patients. Several therapies exist which function through different mechanisms. Better understanding into the pathogenesis will allow for development of newer and more targeted therapies in the future.
and 10-Item Supplement were administered concurrently to patients and disease-free control subjects. High-contrast visual acuities with patient usual distance correction were measured with the use of Early Treatment Diabetic Retinopathy Study (ETDRS) charts.• RESULTS: Diagnoses for patients (n ؍ 215) included optic neuritis, multiple sclerosis, idiopathic intracranial hypertension, ischemic optic neuropathy, stroke, ocular myasthenia gravis, ocular motor palsies, and thyroid eye disease. Scores for the 10-Item Supplement had a significant capacity to distinguish patients vs disease-free control subjects that was independent of the NEI-VFQ-25 composite score (odds ratio in favor of patient vs control status for 10-point worsening in Supplement scores: 2.7 [95% confidence interval [CI], 1.6, 4.6]; P < .001, logistic regression models that account for NEI-VFQ-25 composite score, age, and gender). Patients with visual dysfunction (binocular Snellen equivalents worse than 20/20) had significantly lower mean scores (9 -21 points lower); these differences remained significant after accounting for age and gender (P > .001, linear regression). Supplement items and composite scores demonstrated appropriate degrees of internal consistency reliability.•
We identified characteristics associated with future publication record and academic rank in a cohort of neurology residents from a single institution. Seventy-six percent of women and 94% of men currently hold academic positions (p = 0.10). Early publications may lay the foundation for future academic investigation as publishing before (p = 0.01) and during (p < 0.001) residency was associated with higher post-residency publication rates. Publication differences between women and men (1.5 vs 2.4 publications/year; p = 0.03) warrant further investigation.
Background
Chronic hepatitis C virus (HCV) infection is associated with necrolytic acral erythema (NAE). However, the prevalence of NAE among HCV patients is unknown, and the clinical and histological features have not been well defined.
Objective
To determine the prevalence, overall clinical features, and cutaneous histopathological characteristics of NAE patients.
Methods
A cross-sectional study was performed among chronic HCV-infected patients cared for at three Philadelphia hospitals. Patients completed a questionnaire and underwent a dermatologic examination. All undiagnosed skin lesions with clinical features of NAE as described in the literature underwent skin biopsy.
Results
Among 300 patients with chronic HCV infection (median age, 55 years; 73% male; 70% HCV genotype 1), five (prevalence, 1.7%; 95% CI, 0.5 – 3.8%) had skin lesions consistent with NAE clinically, which were analyzed and confirmed with skin biopsy. All five skin biopsies demonstrated variable psoriasiform hyperplasia, mild papillomatosis, parakeratosis, and necrotic keratinocytes in the superficial epidermis. All 5 patients were >40 years old, African American males, infected with HCV genotype 1 and had a high viral load (>200,000 IU/mL).
Limitations
Previous descriptions of NAE were used to guide the evaluation and need for a biopsy; however, other unknown clinical characteristics of the disease may exist. The senior author was the sole interpreter of the biopsies. Only 300 of the 2500 eligible patients enrolled in the study.
Conclusion
The prevalence of NAE among chronic HCV patients in this sample was very low. Further research is needed to determine the etiology and appropriate therapies of NAE.
To quantify response rates of Sézary syndrome (SS) to multimodality immunomodulatory therapy and to identify the important prognostic parameters that affect overall response to treatment.
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