Abstract:
BACKGROUND:Physicians are important in the early detection of melanoma. We investigated whether primary care physician supply and the supply of dermatologists were related to stage at diagnosis for malignant melanoma. METHODS:From the state tumor registry in Florida in 1994, we identified incident cases of malignant melanoma for which stage at diagnosis was available (N = 1884). Data on physician supply was obtained from the 1994 American Medical Association Physician Masterfile. Logistic regression determined the effects of physician supply (at the ZIP code level) on the odds of early-stage diagnosis controlling for patients' age, gender, race/ethnicity, marital status, education level, income level, comorbidity, and type of health insurance. RESULTS:Each additional dermatologist per 10,000 population was associated with a 39% increased odds of early diagnosis (odds ratio = 1.39, 95% confidence interval [CI] 1.09-1.70, P =.010). For each additional family physician per 10,000 population, the odds of early diagnosis increased 21% (odds ratio = 1.21, 95% CI 1.09-1.33, P <.001). Each additional general internist per 10,000 population was associated with a 10% decrease in the odds of early-stage diagnosis (odds ratio = 0.90, 95% CI 0.83-0.98, P =.009). The supplies of general practitioners, obstetrician/gynecologists, and other nonprimary care specialists were not associated with stage at diagnosis. CONCLUSIONS:Increasing supplies of dermatologists and family physicians were associated with earlier detection of melanoma. In contrast, increasing supplies of general internists were associated with reduced odds of early detection. Our findings suggest that the composition of the physician work force may affect important health outcomes and needs further study.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Roetzheim RG,Pal N,van Durme DJ,Wathington D,Ferrante JM,Gonzalez EC,Krischer JPdoi
10.1067/mjd.2000.106242subject
Has Abstractpub_date
2000-08-01 00:00:00pages
211-8issue
2 Pt 1eissn
0190-9622issn
1097-6787pii
S0190-9622(00)09445-7journal_volume
43pub_type
杂志文章abstract::Langerhans cell histiocytosis (LCH) is a disorder of myeloid neoplasia of dendritic cells that affects 1 in 200,000 children <15 years of age and even fewer adults. LCH presents with a spectrum of clinical manifestations. High-risk stratification is reserved for infiltration of blood, spleen, liver, and lungs. After d...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2017.09.022
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:A task force of the National Psoriasis Foundation Medical Board was convened to evaluate treatment options for pustular psoriasis. Meetings were held by teleconference. Consensus on treatment of pustular psoriasis was achieved. Pustular psoriasis has been classified into localized and generalized forms. Ther...
journal_title:Journal of the American Academy of Dermatology
pub_type: 共识发展会议,杂志文章
doi:10.1016/j.jaad.2011.01.032
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Malignant melanomas occur with increased frequency and at an early age in patients with xeroderma pigmentosum (XP). OBJECTIVE:The purpose of this study was to describe the histologic features of malignant melanomas in patients with XP and to search for a possible precursor lesion. METHODS:Clinical records ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(93)70079-9
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:The histopathological and clinical overlapping features between condyloma acuminata and bowenoid papulosis can present a diagnostic challenge and we sought to determine if immunochemistry can be helpful in this setting. OBJECTIVE:In this study, we evaluate the specificity and sensitivity of p16 immunohistoc...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2013.04.036
更新日期:2013-09-01 00:00:00
abstract::Mycophenolate mofetil (MMF) has been widely used as an immunosuppressant in organ transplantation. MMF has recently been added to therapeutic regimens for skin disorders. Expanding the use of MMF in dermatology, we describe additional patients with autoimmune and inflammatory skin diseases, including 4 cases of pemphi...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(99)70203-3
更新日期:1999-02-01 00:00:00
abstract:UNLABELLED:Skin cancer is the most common cancer in human beings. The increased incidence of skin cancer has brought much attention to the process by which these tumors develop and how they can be prevented. Efforts have been made to educate the public about the importance of protecting skin from excessive ultraviolet ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2005.08.062
更新日期:2006-06-01 00:00:00
abstract::Current classifications for hidradenitis suppurativa (HS), such as the Hurley staging system, are not very specific. The absence of rigorous classifications is incongruous with the clinical variability of the condition. There is no pathognomonic sign for HS that leads to a diagnosis that is unquestionable. Consequentl...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2015.07.047
更新日期:2015-11-01 00:00:00
abstract::Topical nitrogen mustard is an alkylating agent. Its efficacy in treating alopecia areata was reported in an uncontrolled study. We present a preliminary, half-head, controlled 16-week study showing that topical nitrogen mustard was of benefit in 1 of 6 patients treated with 50% to 100% scalp involvement. Another 4 pa...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1067/s0190-9622(03)00800-4
更新日期:2003-08-01 00:00:00
abstract::The deep penetrating nevus (DPN), also known as the plexiform spindle cell nevus, is a pigmented lesion that commonly arises on the head and neck in the first few decades of life. Histopathologically, the DPN is wedge-shaped and contains melanocytes that exhibit deep infiltration into the dermis. Given these features,...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2014.07.026
更新日期:2014-12-01 00:00:00
abstract::Sixty patients were treated for tinea pedis with 2% topical ketoconazole cream either once or twice daily. All diagnoses were confirmed mycologically. They were randomly assigned in a double-blind study into three groups on the basis of their clinical lesions, that is, vesicular pedis, interdigital pedis, and hyperker...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0190-9622(87)70073-5
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Pulsed dye laser treatment and other cosmetic procedures result in significant bruising. Claims have been made regarding the efficacy of topical vitamin K in both preventing and speeding the clearing of bruising; however, well-controlled studies are lacking. OBJECTIVE:The purpose of this study is to evaluat...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mjd.2002.120465
更新日期:2002-08-01 00:00:00
abstract:DISCLAIMER:Adherence to these guidelines will not ensure successful treatment in every situation. Furthermore, these guidelines should not be deemed inclusive of all proper methods of care or exclusive of other methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propri...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2006.08.048
更新日期:2007-04-01 00:00:00
abstract::Dermatofibrosarcoma protuberans (DFSP) is a rare, clinically challenging, soft tissue tumor. The main histologic differential of DFSP is usually a dermatofibroma. In 1990, the first report appeared demonstrating that cells of DFSP express the human progenitor antigen CD34 on their surface. Since then, there have been ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/s0190-9622(97)70146-4
更新日期:1997-09-01 00:00:00
abstract::Scleromyxedema is a rare fibromucinous connective tissue that can be associated with systemic changes, such as myopathy, neurologic defects, esophageal dysmotility, paraproteinemia, and restrictive lung disease. We describe a fatal case of scleromyxedema in which neurologic, cardiac, gastrointestinal, and muscle chang...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/s0190-9622(98)70567-5
更新日期:1998-02-01 00:00:00
abstract::Three patients with advanced atherosclerotic vascular disease developed multiple cholesterol emboli. The clinical presentation typically includes livedo reticularis of the lower part of the body and purple toes. Small areas of necrosis and ulceration may be present distally, despite palpable pulses. Muscular and abdom...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(85)70165-x
更新日期:1985-08-01 00:00:00
abstract::Pruritus is a common and often times difficult to treat symptom in many dermatologic and systemic diseases. For pruritus with an inflammatory or autoimmune origin, therapies such as topical corticosteroids and antihistamines are often initiated. However, in the case that these and additional systemic therapies are ine...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2015.09.039
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Some hereditary palmoplantar keratodermas (PPK) have been defined at the molecular level. OBJECTIVE:Our purpose was to establish the cause of a hereditary PPK with unique histopathologic findings in the epidermis. METHODS:Investigative studies included light and electron microscopy and determination of gen...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(97)70208-1
更新日期:1997-07-01 00:00:00
abstract::The efficacy of a sunscreen containing an investigational drug, butyl methoxydibenzoylmethane in combination with padimate O against the erythemogenic effect of ultraviolet A (UVA) radiation was evaluated in two double-blind studies involving subjects sensitized with topical 8-methoxypsoralen. UVA radiation was suppli...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章
doi:10.1016/s0190-9622(87)70195-9
更新日期:1987-08-01 00:00:00
abstract::Epidermolysis bullosa acquisita is a chronic, severe, subepidermal, blistering disease of the skin, characterized by marked resistance to topical and systemic therapy. This report concerns a well-documented case of a woman who had had epidermolysis bullosa acquisita for 6 years and had remained hospitalized continuous...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(88)70254-6
更新日期:1988-11-01 00:00:00
abstract:BACKGROUND:Differentiation between seborrheic keratosis (SK) and skin cancers may be difficult. Reflectance confocal microscopy (RCM) enables noninvasive assessment of skin neoplasms at cellular-level resolution. OBJECTIVE:We sought to describe RCM features of SK and to correlate these RCM findings with dermoscopic st...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2012.12.969
更新日期:2013-07-01 00:00:00
abstract::To determine whether systemic hydrocortisone can elicit allergic skin reactions in patients with contact hypersensitivity to hydrocortisone, we studied four patients with contact hypersensitivity to hydrocortisone and hydrocortisone-17-butyrate and two patients with contact hypersensitivity to hydrocortisone-17-butyra...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(91)70024-v
更新日期:1991-02-01 00:00:00
abstract::Cutaneous leishmaniasis (oriental sore) is characterized by slowly evolving inflammatory lesion(s) that are nodular, noduloulcerative, or ulcerative and that heal spontaneously with scar(s) in 3 to 12 months. In the course of a comprehensive study of cutaneous leishmaniasis due to Leishmania major in an endemic focus ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(87)70155-8
更新日期:1987-06-01 00:00:00
abstract::Hirsutism in women is frequently associated with increased levels of androgens. Studies of biochemical changes, however, have yielded conflicting results. This study compares the findings in 30 hirsute women with normal menses and those of 30 hirsute women with abnormal cycles. Of the women with abnormal menstruation,...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(90)70011-6
更新日期:1990-01-01 00:00:00
abstract::Many patients with lipoprotein disorders are at increased risk for the development of premature atherosclerosis and, less commonly, other disorders that cause systemic morbidity. In some of these patients, xanthomas also develop and provide cutaneous markers for the lipoprotein disorder. As advances in molecular biolo...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/s0190-9622(88)70157-7
更新日期:1988-07-01 00:00:00
abstract::Palliative care has been shown to improve quality of life, symptom, and caregiver burden for a range of life-limiting diseases. Palliative care use among patients with severe dermatologic disease remain relatively unexplored, but the limited available data suggest significant unmet care needs and low rates of palliati...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2020.08.029
更新日期:2020-08-12 00:00:00
abstract:BACKGROUND:Australia has one of the highest rates of skin cancer globally. Lifetime risk is associated with childhood sun exposure. OBJECTIVE:We sought to investigate whether skin cancer prevention programs have resulted in improvements in sun-exposure and sun-protection behavior among young children in tropical Austr...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2012.10.057
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:The use of immunotherapies in the treatment of metastatic cancers has significantly advanced oncology. However, due to safety concerns, solid organ transplant recipients (SOTRs) are routinely excluded from immunotherapy trials; thus, there is limited data for these agents in this population. METHODS:A syste...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2019.07.005
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Studies of noncutaneous and cutaneous malignancies support the hypothesis that poor risk-perception status contributes to health disparity. OBJECTIVE:We evaluated skin cancer (SC) risk perceptions across race and other demographic markers using the Health Information National Trends Survey (HINTS) and compa...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2011.05.021
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Phototherapy may be effective in atopic dermatitis (AD). Medium-dose (MD) ultraviolet (UV) A1 was introduced for the treatment of AD. Few immunohistochemical data are available pertaining to phototherapy in AD. Regulatory T cells may play a role in clearing AD. OBJECTIVES:We sought to compare the clinical a...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jaad.2008.08.048
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Often after biopsy a skin cancer appears to resolve clinically and a repeat biopsy may be done on the area in question before proceeding with further treatment. OBJECTIVE:Our purpose was to assess the value of a subsequent biopsy in the treatment of skin cancers previously diagnosed by biopsy results. METH...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(92)70159-d
更新日期:1992-07-01 00:00:00