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Cleveland Clinic Journal of Medicine
Puffy Hand Syndrome
A 37-year-old man presented with persistent swelling, limited range of motion, and loss of hand dexterity in both hands. He had a history of IV drug use, including opiates and methamphetamine. The examination showed diffuse swelling without joint inflammation. Lab tests were normal, and imaging revealed soft-tissue swelling. The diagnosis was puffy hand syndrome, a common complication of IV drug use. Treatment options are mainly symptomatic, including discontinuation of IV drug use and the use of low-stretch bandages and compression gloves. Puffy hand syndrome, often unrecognized by general practitioners, should be considered in patients with swelling and limited hand function who have a history of IV drug use. The syndrome involves progressive fibrosis of subcutaneous tissues due to repeated injection-induced vascular and dermal sclerosis. Diagnosis is based on clinical presentation, history, and evaluation ruling out other conditions. Treatment focuses on symptomatic relief and cessation of IV drug use.
Dermatology May 18th 2023
Derm Dx: Black Discoloration of the Hands
A 75-year-old man visited the dermatology clinic with concerns about multiple actinic keratoses and a black discoloration on his right hand and fingers. It is noteworthy that over the past 12 to 14 years, during his retirement, the patient has experienced black discoloration on his right hand after peeling apples for pies multiple times each year. This discoloration occurs on the hand that holds his carbon knife and stainless steel peeler and typically disappears within a few days. Upon examination, the right palm exhibited black macular discoloration along the skin lines, particularly prominent on the palmar aspect of the fingers. The patient’s hands also displayed dryness and roughness upon palpation. Can you identify the diagnosis?
Dermatology May 18th 2023
Worsening Spread of Candida auris in the United States, 2019 to 2021
Based on cases reported to the CDC, this study reports an acceleration in case detection, with a dramatic increase in 2021. From 2019 to 2021, 17 states identified their first case of C auris; however, resistance to echinocandins increased threefold in 2021 compared to the previous two years. And because screening is not conducted uniformly across the United States, the true burden of C auris cases is likely higher than reported.
Allergy & Immunology April 5th 2023
The New England Journal of Medicine
Neoadjuvant–Adjuvant or Adjuvant-Only Pembrolizumab in Advanced Melanoma
Event-free survival was significantly longer in patients with resectable stage III or IV melanoma who received pembrolizumab both before and after surgery than in those who received adjuvant pembrolizumab alone. New toxic effects were not discovered.
Dermatology March 6th 2023
Integrating Immune Checkpoint Therapy Into the Management of Resectable Melanoma
Lack of Concordance Between Radiologic and Pathologic Responses in Neoadjuvant ICI Treatment of Melanoma: How Do I Assess Radiologic Progression? After taking part in this CME activity, medical oncologists, surgeons, dermatologists, oncology nurses, oncology pharmacists, and other members of the interprofessional team who manage patients with melanoma should be better able to:
Dermatology February 27th 2023
Monthly Prescribing Reference (MPR)
Cibinqo Approved for Adolescents with Moderate to Severe Atopic Dermatitis
Approved for AD in adults a year ago, abrocitinib is now available for individuals over 12 years old with moderate to severe atopic dermatitis that is not adequately controlled with other systemic therapy.
Dermatology February 23rd 2023