Abstract:
BACKGROUND:The dysplastic melanocytic nevus (DMN) is a putative precursor for malignant melanoma in persons with a family history of melanoma and multiple large atypical moles. Furthermore, the concept that DMN confers increased risk for melanoma has been extended to those without a family history of melanoma. Some investigators have characterized DMN in terms of size, surface topography, and irregularity of border and color and have provided definitive statements as to major and minor clinical "criteria" for DMN. OBJECTIVE:In this study we conducted a quantitative test of previously described clinical characteristics in patients diagnosed with melanoma but without a family history of melanoma in a first-degree relative (N = 153). METHODS:Two of us examined each patient independently, counting the total number of nevi, deciding on the most clinically atypical nevus, and recording quantitatively the size, surface, border, and color characteristics. The most atypical nevus was removed from each patient and diagnosed histologically without knowledge of the clinical examiner's description. RESULTS:Of the 153 nevi so examined, 91 (59.5%) were judged to be clinically atypical and 23 nevi (15%) were classified as histologically dysplastic. We then analyzed the ability of each clinical feature to predict histologic melanocytic dysplasia. A multivariate analysis was conducted with the blindly scored clinical features as independent variables. Independent variables included total number of nevi and freckles as well as the features of the particular nevus biopsied (including longest diameter, macular component, irregular border, ill-defined border, haphazard coloration). Of the many independent clinical variables, only total number of nevi and macular component were useful in the final multivariate prediction. Of 21 nevi with a macular component removed from persons with more than 24 total body nevi, 7 were histologically dysplastic, representing a positive predictive value of 33.3% (95% exact confidence limits 14.6% to 57.0%). Of the 38 nevi without a macular component to their most atypical nevus removed from patients with 12 or fewer total body nevi, 37 failed to meet histologic criteria for DMN, representing a negative predictive value of 97% (95% exact confidence limits 86.2% to 99.9%). CONCLUSION:We conclude that in nonfamilial melanoma, clinical criteria suggesting DMN when present will often fail to display histologic melanocytic dysplasia. In contrast, absence of a macular component in melanocytic nevi in a person with fewer than 13 total body nevi will accurately predict the absence of melanocytic dysplasia on histologic examination.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Roush GC,Dubin N,Barnhill RLdoi
10.1016/0190-9622(93)70221-esubject
Has Abstractpub_date
1993-10-01 00:00:00pages
555-62issue
4eissn
0190-9622issn
1097-6787pii
0190-9622(93)70221-Ejournal_volume
29pub_type
杂志文章abstract:BACKGROUND:Flushing and erythema are frequent skin symptoms in rosacea. Because their adequate treatment remains a clinical challenge, new treatment options are explored, such as oral β-blockers. OBJECTIVES:To evaluate the efficacy of oral β-blockers for rosacea-associated facial flushing and erythema. METHODS:PubMed...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2020.04.129
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Extramammary Paget disease (EMPD) sometimes shows an ill-defined border and an unexpectedly extended tumor spread beyond the clinical borders. Mapping biopsy is 1 approach for complete surgical removal, but its efficacy has remained controversial. OBJECTIVE:We sought to evaluate mapping biopsies for EMPD. ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2017.12.040
更新日期:2018-06-01 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:Genital or vulval lichen planus (VLP) may have a disabling effect on a patient's quality of life. Evidence-based management guidelines are lacking for VLP. OBJECTIVE:We sought to review clinical presentation and treatment of patients who received a diagnosis of VLP. METHODS:The 100 consecutive patients who...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2017.07.030
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Preventing fetal exposure to isotretinoin is an important public health goal. Since approval of isotretinoin (1982), the Food and Drug Administration has implemented several unsuccessful risk management programs aimed at preventing fetal exposure. The Kaiser Permanente isotretinoin risk management program in...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2006.05.018
更新日期:2006-09-01 00:00:00
abstract::Oral juvenile xanthogranuloma is a rare condition, with only 10 histologically proven cases previously described. A histologically unusual variant is reported here, diagnosis of which was aided by the use of immunohistochemical stains. Previously reported cases are reviewed, and their characteristics are tabulated and...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/0190-9622(95)91438-2
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:Atopic dermatitis (AD), a chronic, highly pruritic skin disorder, impairs quality of life (QoL). Janus kinase inhibitors suppress inflammatory and pruritus-associated cytokine signaling in AD. OBJECTIVE:To report the effects of ruxolitinib (RUX) cream on itch and QoL in AD. METHODS:A total of 307 adult pat...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jaad.2020.02.009
更新日期:2020-06-01 00:00:00
abstract::Six men suffering from acute dermatitis had positive patch tests to Larrea (creosote bush). The lesions preferentially involved sun-exposed sites, simulating a photodermatitis, but also were on the legs and scrotum. Our findings were more consistent with contact allergy than with a primary irritant or a phototoxic res...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(86)70022-4
更新日期:1986-02-01 00:00:00
abstract::An unusual American epidemic consisting of twenty cases of granuloma inguinale is chronicled. Evidence from this series supports the venereal transmission of the disorder. Trimethoprim/sulfamethoxazole proved to be a safe and effective therapy. ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章
doi:10.1016/s0190-9622(84)70186-1
更新日期:1984-09-01 00:00:00
abstract::A technique involving modification of the routine paraffin embedding procedure that allows immunohistochemical examination of extracellular antigens by light microscopy is described. The method is thus suitable for routine diagnostic immunofluorescence studies, permitting reliable, reproducible immunolabeling of immun...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(88)70232-7
更新日期:1988-10-01 00:00:00
abstract::We report on a patient with a syndrome characterized by smooth facial papules and nodules; alopecia of the eyebrows, eyelashes, and most body hair; mild alopecia of scalp hair; possibly hypohidrosis; and myasthenia gravis. The clinical, histologic, and immunohistochemical findings are compared with classic and desmopl...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(86)70274-0
更新日期:1986-11-01 00:00:00
abstract::There has been a resurgence of syphilis in the past decade. Uncommonly, diffuse hair loss, termed essential alopecia, is the only sign of syphilitic infection. We describe two patients with syphilis in whom the first sign of disease was alopecia and discuss the clinical and histopathologic findings of essential syphil...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/0190-9622(95)91543-5
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Topical antibiotics are not indicated for routine postoperative care in clean dermatologic procedures, but may be widely used. OBJECTIVE:We sought to describe topical antibiotic use in clean dermatologic surgical procedures in the United States. METHODS:The 1993 to 2007 National Ambulatory Medical Care Sur...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2011.02.005
更新日期:2012-03-01 00:00:00
abstract::The usual method of treatment of pilomatricoma (calcifying epitheliona of Malherbe) is excision. We present a review of eight patients with ten tumors treated by incision and curettement. Follow-up ranged from 1 to 10 years, and there have been no recurrences. An alternative method of therapy with excellent results is...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(80)80291-x
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:Maternal smoking during pregnancy has been shown to lead to immunologic changes in the offspring. However, little is known about the influence of this exposure on atopic manifestations. OBJECTIVE:Our purpose was to investigate the influence of air pollutants on manifestations of atopy in preschool children....
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(97)70242-1
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Acral vascular syndromes associated with malignancy have rarely been reported. OBJECTIVE:Our purpose was to assess the clinical and evolving features of paraneoplastic acral vascular syndromes. PATIENTS AND METHODS:Two cases of paraneoplastic gangrene are described and analyzed together with previously rep...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1067/mjd.2002.120474
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Giant angiofibromas in patients with tuberous sclerosis complex (TSC) are rare. OBJECTIVE:We sought to report two patients who had TSC with unusually large and disfiguring facial angiofibromas and to identify underlying histopathologic changes that may possibly explain the clinical features. METHODS:We per...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2012.03.021
更新日期:2012-12-01 00:00:00
abstract::Nevoid hyperkeratosis of the nipple and areola, which is characterized by verrucous thickening and pigmentation of the nipple or areola, is a rare condition. Different therapeutic options have been used with varying results, but there is no uniformly effective treatment. We describe two patients with hyperkeratosis of...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1067/mjd.2002.117848
更新日期:2002-01-01 00:00:00
abstract:UNLABELLED:Mycophenolate mofetil (MMF) is the prodrug of mycophenolic acid (MPA), a medication used to treat psoriasis in the 1970s until side effects and the concern of carcinogenesis led to its discontinuation. The prodrug, MMF, emerged decades later in the transplant field. Dermatologists have since used MMF off-lab...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/j.jaad.2008.08.049
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:The color, architecture, symmetry, and homogeneity (CASH) algorithm for dermoscopy includes a feature not used in prior algorithms, namely, architecture. Architectural order/disorder is derived from current concepts regarding the biology of benign versus malignant melanocytic neoplasms. OBJECTIVE:We sought ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2006.09.003
更新日期:2007-01-01 00:00:00
abstract::This case describes an unusual presentation of dermatomyositis in a patient with ovarian carcinoma. The eruption appeared as a venous stasislike dermatitis. The temporal sequence of onset after chemotherapy administration suggested a possible drug-induced process. However, in the context of underlying ovarian carcinom...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2008.02.033
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Little is known about how individuals with a predisposition for rosacea appear in childhood. This retrospective, matched control, longitudinal study examined the relationship between childhood stye and adult rosacea. METHODS:The records of the Rochester Epidemiology Project were examined to identify patient...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2006.03.023
更新日期:2006-12-01 00:00:00
abstract::Pachyonychia congenita is a rare genetic disorder classified in clinical subtypes. Late onset of the disease has recently been described and designated as pachyonychia congenita tarda. A patient in whom typical manifestations of pachyonychia congenita appeared at the age of 39 years is described. This report substanti...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(96)90663-5
更新日期:1996-08-01 00:00:00
abstract::Intravascular lymphomatosis (IVL) is a rare type of lymphoma with a poor prognosis. Its distinctive clinical and histopathologic features are generated by the proliferation of neoplastic mononuclear cells within blood vessels. We describe a patient with IVL of the skin as a manifestation of a recurrent diffuse large B...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1067/mjd.2003.112
更新日期:2003-02-01 00:00:00
abstract::A 1 U/ml solution of bleomycin sulfate in physiologic saline solution was injected intralesionally in 38 patients, and was compared with physiologic saline solution injection into paired warts in the same patient. No patient received more than 2 ml of bleomycin. Ninety-seven of 143 warts (67.8%) showed complete resolu...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章
doi:10.1016/s0190-9622(88)70140-1
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:In response to the increasing rate of skin cancer, particularly melanoma in the United States, the Environmental Protection Agency, the National Weather Service, the Centers for Disease Control and Prevention, National Association of Physicians for the Environment, and the American Academy of Dermatology, de...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(97)70068-9
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Rituximab has been increasingly used in autoimmune blistering dermatoses, mainly in pemphigus. However, only a few larger case series are available on this subject and information on the efficacy of retreatment with rituximab during relapses is lacking. OBJECTIVE:We sought to determine efficacy and adverse ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2010.07.032
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Spindle cell melanoma (SCM) including desmoplastic melanoma (DM) is a rare variant of malignant melanoma that may present diagnostic difficulties particularly when staining with S100 is negative, weak, focal, or a combination of these. Conventional melanocytic markers in SCM are usually negative. OBJECTIVE:...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2009.11.688
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Intertriginous and facial involvement are manifestations of psoriasis that require a different approach than is used for typical plaque psoriasis on other skin areas. Topical corticosteroids are the primary treatment for psoriasis; however, the side effects of corticosteroids are magnified on intertriginous ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jaad.2004.07.011
更新日期:2004-11-01 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