Felton M.,Felton S.,Kay N; Journal of the American Academy of Dermatology, May 2014

Bilateral superficial granulomatous pyoderma of the auricular and periauricular skin

Journal of the American Academy of Dermatology, May 2014
Author(s): Felton M.,Felton S.,Kay N.
Abstract:  A 36-year-old presented with a 3-month history of a nonhealing 5-mm diameter ulcer in the left conchal bowl. Swabs revealed no bacterial growth, and blood tests, including eosinophil count, were normal and antineutrophil cytoplasmic antibody negative. Histology from excisional biopsy, performed because of suspected malignancy, described extremely acanthotic squamous epithelium with ulcerated areas lined by palisading histiocytes. The dermis had a neutrophilic and in some areas eosinophilic infiltrate, again with palisading histiocytes. The cartilage was degenerate but not inflamed. There was no dysplasia. The key diagnosis proposed was superficial granulomatous pyoderma. The other histologic differentials, infection and systemic vasculitis, were excluded clinically. Unfortunately, he subsequently developed marked ulceration across the ipsilateral periauricular skin and within the contralateral conchal bowl. Some areas have healed with cribriform scarring. Treatment with high-dose oral prednisolone and azathioprine did not provide sustained improvement. Minocycline and dapsone had limited success, whilst more recently he has commenced anti-tumor necrosis factor therapy with infliximab after excluding underlying malignancy.

Van Der Ploeg, N; Hamer, D; European Journal of Surgical Oncology, May 2014

Breast care clinical nurse specialist led follpw up for patients who have undergone breast cancer surgery and have annual mammography

European Journal of Surgical Oncology, May 2014 vol/iss 40/5/(636), 0748-7983

Source: Embase

Abstract: Patients have annual mammograms for six years post diagnosis of breast cancer, they are seen within one hour of having their mammograms by a clinical nurse specialist, for clinical examination, results of mammography and follow up. The aim of the study was to evaluate whether patients were satisfied with the service or whether the process was more stressful than returning two weeks later for the results at a further appointment and whether they would prefer to see a doctor rather than a nurse. Method: The data was collected via questionnaire completed by the patient after they have attended for the follow up visit. All responses were anonymous. Results: Data was collected for one month in September 2013, 100 questionnaires were completed. This included patients who had undergone wide local excision, mastectomy +/- reconstruction of the breast. 100% of patients were very happy to be seen by a breast care specialist nurse. 100% of patients valued the service and found it less stressful having one visit to the hospital and receiving the results on the same day, 96% felt that any concerns were addressed at the consultation, 4% had no concerns.

Conclusion: Receiving mammogram results within one hour of having the mammogram significantly reduces level of anxiety in patients and seeing a breast care specialist nurse results in a very high level of patient satisfaction.

This article can be ordered through our inter-library loan scheme.

 

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BMJ: table of contents May 27 2014

Here is the table of contents for the BMJ (27 May). Use the links to access the articles and have your Athens account details to hand to read the full-text.


Editor’s choice
Navjoyt Ladher
Editorials
Mark D Huffman
James Raftery and Christopher Newdick
Karl Michaëlsson
Ruth Cairns, Matthew Hotopf, and Gareth S Owen
Letters
Mark Porter and David Richmond
News
Ingrid Torjesen

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