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The purpose of this population-based study was to assess trends in mortality rates for nonmelanoma skin cancer (NMSC) in the United States. Particular emphasis was placed on the subgroup of malignancies arising on genital skin. Nearly 75,000 deaths in the United States were attributed to NMSC from 1969 to 2000. The age-adjusted US mortality rate for NMSC arising on nongenital skin from 1969 to 2000 was 0.69/10(5)/year; the rate among men was twice that among women. Mortality rates among white men exceeded that of black men by a factor of two; the same was observed among women, but by a smaller multiple. Corresponding mortality rates for malignancies arising from genital skin (penis, scrotum, vulva) were higher in women (0.54) than in men (0.30). In contrast to nongenital NMSC, mortality rates among black men were twice that of white men; however, rates for white and black women were similar. These results suggest that greater emphasis could be placed on reducing mortality from genital NMSC while continuing to stress reduction of excess sun exposure.

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BACKGROUND The frequency of postoperative bleeding and other complications in anticoagulated patients undergoing cutaneous surgery has not been firmly established and consensus on perioperative continuation of treatment is lacking. OBJECTIVE The objective was to ascertain the risk of postoperative complications through meta‐analysis of data pooled from previously published studies. METHODS A PubMed search (1966–2005) was performed to identify controlled studies reporting bleeding and other complications among patients undergoing cutaneous surgery who were taking anticoagulant medications. Emphasis was placed on prescription anticoagulant medications (aspirin, NSAIDs, warfarin, clopidogrel) and over‐the‐counter herbal agents with anticoagulant properties. RESULTS A total of six studies representing 1,373 patients met criteria for inclusion. Among patients taking aspirin or warfarin, 1.3 and 5.7% experienced a severe postoperative complication, respectively. Patients taking warfarin were nearly seven times as likely to have a moderate‐to‐severe complication compared to controls (OR, 6.69; 95% CI, 3.03–14.7), a statistically significant difference (p<.001). Patients taking aspirin or NSAIDs were more than twice as likely to have a moderate‐to‐severe complication compared to controls (OR, 2.0; 95% CI, 0.97–4.13), a strong trend toward statistical significance (p=.06). There were no studies in the literature that examined the effects of combination anticoagulant therapy or the effect of herbal agents on postoperative risk of bleeding. CONCLUSION The results of this meta‐analysis suggest that while low, the risk of bleeding among anticoagulated patients may be higher than baseline. Adequately powered prospective studies are required to more carefully delineate the risk of postoperative bleeding and other complications attributable to anticoagulation therapy. Particular emphasis should be placed on examining the effect of combination anticoagulant therapy as well as herbal agents with anticoagulant properties on risk of bleeding after cutaneous surgery.

Nephrogenic fibrosing dermopathy (NFD) and calciphylaxis are rare conditions that are associated with chronic kidney disease. Histopathologic changes, including dystrophic dermal calcification, often in association with elastic fibers have been observed in NFD and calciphylaxis. A pattern of dermal elastic fiber calcification that mimics pseudoxanthoma elasticum (PXE) has been previously reported as an incidental finding in the setting of calciphylaxis. Despite a shared association with renal disease and abnormal calcium deposits, however, NFD and calciphylaxis are discrete pathologic processes with distinct clinical and histopathologic features. Criteria for each are reviewed through case presentation of a patient meeting the clinical and histopathologic criteria for both NFD and calciphylaxis with histologic features mimicking PXE.

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