UPDATES IN MEDICAL DERMATOLOGY
Iam pleased to present you with this issue of Seminars in
Cutaneous Medicine and Surgery on the topic of Updates in
Medical Dermatology. Over the past decade or so, a great
emphasis has been placed on procedural and cosmetic dermatology,
causing many experts in our field to be concerned
that the scope of dermatology is narrowing. The management
of psoriasis, atopic dermatitis, cutaneous T-cell lymphoma
(CTCL), melanoma, and wound healing is often now done by
nondermatology providers—rheumatologists, allergists, oncologists,
and others. With the many advances in the understanding
of these cutaneous disease processes— having implications
for diagnosis, prognosis, and treatment—there is a
broad scope where we as a profession can have an impact.
This issue will update the reader on important medical dermatology
topics, such as atopic dermatitis, CTCL, melanoma,
and wound healing. It will also provide the reader with a
thorough review of two of the most controversial vitamins—
vitamin A and vitamin D.
This issue begins with a comprehensive and clinically useful
update on the “sunshine vitamin.” Dr Gilchrest has published
extensively on this topic and dispels myths propagated
by the media and supplement industry. The next article by Dr
Chapman highlights the other important and controversial
vitamin, vitamin A, offering the reader insight into the controversy
and confusion that surrounds isotretinoin therapy.
Moving away from the vitamins and to other hot medical
dermatology issues, Dr Armstrong’s group highlights advances
in the treatment of atopic dermatitis since it was last
reviewed in Seminars in Cutaneous Medicine and Surgery in
June 2008. Dr Peter Heald, a world’s expert in CTCL, presents
his “menus for the management” of CTCL. An update on
wound healing by Dr Tania Phillips both reviews important
wound management issues and highlights new advances in
this field. The final two articles are dedicated to melanoma, a
disease which in its advanced stages has remained incurable
and a focus of much research. Dr Kim’s group summarizes
imaging technologies for pigmented lesions, highlighting
those advances since the September 2009 issue of Seminars in
Cutaneous Medicine and Surgery. With recent advances in the
understanding of the molecular and immunologic mechanisms
of melanoma, Dr Krathen updates the reader on the
ever-changing areas of diagnosis, prognosis, and treatment of
It has been my pleasure to work with this group of esteemed
dermatologists. Their thoughtful contributions make
this update in medical dermatology fascinating, and I hope
will remind the reader of the breadth of our wonderful field.
The incidence of melanoma is on the rise, and early detection of disease is imperative to
reduce mortality. Dermatologists are key players in the early detection of melanoma;
however, some clinicians rely on their clinical examination without any additional diagnostic
tools to make this important diagnosis. Certain patients, such as atypical nevus patients,
have more complicated mole examinations, making the diagnosis of melanoma difficult,
whereas some melanomas, such as amelanotic melanomas, can be diagnostically challenging.
The goal of the clinician is to detect melanoma with the highest accuracy, while
avoiding unnecessary biopsies. Using diagnostic melanoma tools as an adjunct to the
clinical examination, dermatologists have the opportunity to increase both their sensitivity
and specificity for melanoma detection. This article will review current imaging technologies
and those in development for pigmented lesions, updating the clinician on basic
principals of such modalities and clinical use of such technologies in practice.
Semin Cutan Med Surg 31:38-44 © 2012 Elsevier Inc. All rights reserved.
The detection of cutaneous melanoma still largely relies on clinical suspicion, skin biopsy,
and histopathologic evaluation. New technologies are being evaluated to bypass the skin
biopsy in the detection of melanoma. The quest for reliable biomarkers, with respect to
subclinical detection, prognosis, and predicting treatment response, is longstanding and
ongoing. New therapies have been developed for metastatic disease, including targeted
small molecule inhibitors as well as immune modulators.
Semin Cutan Med Surg 31:45-49 © 2012 Elsevier Inc. All rights reserved.
In the September 2011 article “Approach to Pediatric Acne Treatment: An Update” (vol 30, no 3S, page S19), Table 4 incorrectly
lists the active ingredients of Epiduo. Epiduo’s active ingredients are benzoyl peroxide and adapalene. The corrected table is