Deborah F Macfarlane

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A 41-year-old human immunodeficiency virus (HIV)-positive man was hospitalized with complaints of a 4-week history of nausea and vomiting, associated with decreased oral intake, and a 4-day history of frontal headache and fever. His medical history was significant for a gunshot wound to the head 3 years prior, with a residual seizure disorder. He also had(More)
BACKGROUND Merkel cell carcinoma (MCC) is a rare, aggressive, cutaneous neoplasm. The primary form of initial treatment is wide surgical excision. The use of Mohs micrographic surgery as the primary form of treatment in MCC has been controversial. The course of MCC is often aggressive, with early metastasis, widespread disease, and death. Despite the poor(More)
BACKGROUND Exposure to tanning beds, which contain mostly high-dose UV-A emitters, is a known cause of photoaging. Evidence is also accumulating for an association between tanning bed use and the development of skin cancer. Another source of high-dose UV-A is UV nail lights, available for use in the home and in beauty salons. OBSERVATIONS Two healthy(More)
BACKGROUND One option for the treatment of cutaneous tumors in the very elderly has been simple observation. However, the combination of an increasing elderly population and a concomitant high incidence of skin cancer will make this problem more common. OBJECTIVE To assess the suitability of Mohs micrographic surgery as a treatment modality for skin(More)
BACKGROUND Quantitative data on soft tissue aging of the face are scarce, particularly in men. OBJECTIVE Magnetic resonance imaging (MRI) was used to quantify and compare facial soft tissue loss in men. MATERIALS AND METHODS Two thousand thirty-seven MRIs were screened and 30 male subjects were divided into young, middle, and old-aged groups. A blinded(More)
BACKGROUND The population of people aged 90 years and older is expected to more than triple by 2050. The incidence of skin cancers is increasing. OBJECTIVE We sought to determine whether treatment of patients aged 90 years and older with skin cancer by Mohs micrographic surgery (MMS) changed their survival. METHODS A group of 214 patients aged 90 years(More)
Overexposure to ultraviolet and visible radiation causes sunburn. Aspirin and other nonsteroidal anti-inflammatory drugs, cool baths and topical steroids offer only mild relief. Long-term sun exposure causes chronic inflammatory skin changes. Photodamage, rather than the normal aging process, may account for 90 percent of age-associated cosmetic skin(More)
Cosmetic procedures are growing in popularity and are associated with unique risks. Considering potential complications and prioritizing patient safety will help practitioners improve outcomes of elective procedures. In part II of this continuing medical education article, we provide a comprehensive review of patient safety in cosmetic procedures, including(More)
tients showed inflammatory lesions that waned after MEL treatment (P .003), and 5 patients had hyperkeratotic lesions that subsequently disappeared (P .02). Three of 13 patients’ areas of disease showed decreased infiltration during the study. Six patients reported scalp pain before or during the study, but none by the end (P .008). While 10 of 13 patients(More)
A thorough knowledge of the techniques used in skin grafting is a necessity for successful soft-tissue reconstruction. Careful attention to detail and planning should ensure an excellent outcome. Current research in the fields of tissue engineering and skin substitutes continues to evolve with the ultimate goal being tissue-engineered skin that matches the(More)