Indoor tanning is associated with a significantly increased risk of both basal and squamous cell skin cancer. The risk is higher with use in early life (<25 years). This modifiable risk factor may account for hundreds of thousands of cases of non-melanoma skin cancer each year in the United States alone and many more worldwide. These findings contribute to the growing body of evidence on the harms of indoor tanning and support public health campaigns and regulation to reduce exposure to this carcinogen.

The Patient's StoryMr A is 85 years old and has multiple skin abnormalities with intractable pruritus of the trunk, groin, perianal area, face, and scalp. He cannot sleep for more than 4 to 5 hours per night because of his pruritus. Mr A was diagnosed as having seborrheic dermatitis, lichen simplex chronicus, seborrheic keratoses, tinea pedis, intertrigo, and xerosis (dry skin) in 2000. Treatments included numerous topical steroids and antifungals. None were effective, leaving Mr A significantly stressed.Mr A lives with his wife in an assisted-living facility. He requires help with dressing, transferring, using the telephone, shopping, and managing medications. His medical history includes type 2 diabetes mellitus, obesity, chronic kidney disease, and significant cardiovascular, cerebrovascular, and peripheral vascular disease. He has had 2 coronary artery bypass graft operations, 2 left carotid endarterectomies, and a left femoral-popliteal bypass operation. He also underwent multilevel lumbar laminectomy for spinal stenosis.His list of 28 oral and inhaled medications includes rosuvastatin and amlodipine. At one visit to Dr I, his geriatrician, Mr A produced 14 different tubes of topical medications, including multiple steroids and antifungals. He and his wife did not understand when and where to apply these medications. Mr A's skin was dry, with erythematous patches, seborrheic keratoses, and areas of excoriation on his trunk. He had bilateral inguinal fold and perianal erythema with a few white perianal plaques and several fissures. On monofilament testing, cutaneous sensation in his feet was absent. Screening for depression was unrevealing. His laboratory test results were notable for mild anemia, elevated creatinine, and normal liver function and routine chemistries.Mr A had several UV-B light treatments, which were minimally helpful. Mr A used over-the-counter diphenhydramine to help him sleep even though Dr I had advised against it because of potential anticholinergic adverse effects. Ultimately, Dr I, in collaboration with IMPORTANCE Pruritus is a common problem among elderly people and, when severe, causes as much discomfort as chronic pain. Little evidence supports pruritus treatment, limiting therapeutic possibilities and resulting in challenging management problems.OBJECTIVES To present the evidence on the etiology, diagnosis, and treatment of pruritus in the elderly and, using the best available evidence, provide an approach for generalist physicians caring for older patients with pruritus.EVIDENCE REVIEW PubMed and EMBASE databases were searched (1946( -August 2013.The Cochrane Database of Systematic Reviews and the Agency for Healthcare Research and Quality Systematic Review Data Repository were also searched from their inception to August 2013. References from retrieved articles were evaluated.FINDINGS More than 50% of elderly patients have xerosis (dry skin). Xerosis treatment should be included in the initial therapy for pruritus in all elderly patients. Calcium channel blockers and hydrochlorot...

Our meta-analysis suggests a potentially beneficial effect of statins on prostate cancer patients treated with RT but not among radical prostatectomy patients. Although limited by the lack of randomized data, these results suggest that primary treatment modality should be considered in future studies examining associations between statins and oncologic outcomes.

Background European studies have shown that itch is a widespread symptom, yet little is known about its frequency in the U.S. Objective To describe ambulatory care visits to clinicians in the U.S. for which itch was coded as a patient symptom. Methods This study uses retrospective data from the National Ambulatory Medical Care Survey from 1999–2009. Results Itch was coded as a symptom for an average of 7 million visits per year or approximately 1% of all outpatient visits, which was nearly 40% of the number of visits for the symptom of low back pain. Patients seen in visits for itch were more likely to be black or Asian than other patients (20% vs. 14%). They were also more likely than other patients to receive a new medication (68% vs. 36%) and were over twice as likely to receive two or more new medications (31% vs. 14%). Limitations Secondary datasets may not optimally capture patient reports and some of the procedures or medications may have been ordered for reasons other than itch. Conclusion Visits to clinicians for itch represent a sizeable proportion of ambulatory care visits in the US, and research on the epidemiology, treatments, and causes of itch should be a priority.

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A cne is one of the most common skin diseases, with an estimated prevalence of 50 million people in the United States alone, and has a significant impact on quality of life. The high prevalence and seriousness of acne makes crafting innovative avenues for patient education about this disease very important. Twitter has become a popular social networking phenomenon with a user base of over 140 million active users and 340 million tweets per day. 1 Its popularity makes it a potentially powerful source of information and route of communication for acne, especially since the Internet can be an adolescent's primary sources of health information. 2 Methods. Twitter is an online social networking service that allows users to post 140-character messages called "tweets" and to subsequently repost or "retweet" these messages from their own account. Using a form of realtime data capture through the use of the Twitter Streaming Application Programming Interface (API), we obtained an institutional review board-exempt status and collected all tweets that contained 1 or more of 5 keywords: pimple, pimples, zit, zits, and acne for a 2-week period from June 10 through June 23, 2012, with additional data monitoring in order to calculate a 1-week retweet count for each tweet. We applied an English filter that we determined had a 93% sensitivity and 97% specificity. 3 These data were then exported as a commaseparated values (CSV) file via the TwitterToCSV software library that one of us (A.C.) developed for this research and that we have made available as an opensource package. 4 High-impact tweets, defined as tweets with one or more retweets, were the only tweets examined in this study. These high-impact tweets were frequency weighted by retweet count and categorized by content into 4 main categories: personal, celebrity, education, and irrelevant/excluded. The education category was further subdivided into: disease question, disease information, treatment question, treatment information (branded), treatment information (non-branded), and treatment information (ambiguous). The language and content of these highimpact tweets were then compared to the acne patient information website published by the American Academy of Dermatology (AAD). 5

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