This Month in Archives of Dermatology Comparison of Skin Biopsy Triage Decisions in 49 Patients With Pigmented Lesions and Skin Neoplasms Store-and-Forward Teledermatology vs Face-to-Face Dermatology T eledermatology is a rapidlygrowing discipline that ad- dresses issues of access to and qual- ity and cost of dermatologic care. In this prospective study of 49 consecu- tive patients judged by an internist to require dermatologic consulta- tion for skin neoplasms, Shapiro et al compared skin biopsy triage deci- sions by 3 experienced observers us- ing store-and-forward teledermatol- ogy and face-to-face consultations. Remarkably, 100% agreement in treatment plan was observed be- tween the face-to-face and teleder- matologic consultations. The au- thors comment on issues surrounding the cost-effectiveness of this technol- ogy that will ultimately impact the in- tegration of teledermatology into real- world practice settings. See page 525 The Framingham School Nevus Study A Pilot Study M alignant melanoma is morecommon among people with numerous nevi. Our current under- standing of the evolution of nevi de- rives mainly from cross-sectional studies. In this population-based survey and 1-year prospective fol- low-up study of a cohort of 52 schoolchildren, Oliveria et al dem- onstrate the feasibility of perform- ing a longitudinal study to address patterns of nevus evolution. In ad- dition, they describe the preva- lence and patterns of nevi among schoolchildren using digital pho- tography and dermoscopic features to explore the interrelationship be- tween nevi and host and environ- mental factors. See page 545 Management of Lentigo Maligna and Lentigo Maligna Melanoma With Staged Excision A 5-Year Follow-up L entigo maligna (LM) and LM melanoma are pigmented melanocytic neo-plasms found mainly on the sun-exposed skin of the head and neck in elderly patients. In this retrospective follow-up study of 59 patients with LM or LM melanoma who had the lesion excised with serial excision, Bub et al describe the utility of radial histologic sectioning in preparing the tissue. This technique allows the dermatopathologist to examine multiple sections start- ing from the center of the tumor and working toward the periphery. The av- erage margin excised was 0.55 cm, and patients were observed for a mean of 57 months after surgery. Only 3 local recurrences and no evidence of meta- static disease were observed, a cure rate that exceeds that of conventional sur- gery and carries the benefits of tissue conservation. See page 552 Acaricidal Activity of Melaleuca alternifolia (Tea Tree) Oil In Vitro Sensitivity of Sarcoptes scabiei var hominis to Terpinen-4-ol S cabies is a worldwide ectoparasitic disease of the skin caused by the miteSarcoptes scabiei. Current therapies for ordinary scabies consist primar- ily of topical agents, although oral ivermectin has been used in some settings. The essential oil of the tea tree is an Australian Aboriginal traditional medica- tion for bruises, insect bites, and skin infections, although little is known of its antiectoparasitic activity. The primary active components of tea tree oil (TTO) are oxygenated terpinoids. In this pilot study, Walton et al evaluated the anti- scabetic efficacy of TTO through in vitro and in vivo assays and demonstrated that TTO may represent an effective novel agent for the treatment of scabies. See page 563 Association of Solitary, Segmental Hemangiomas of the Skin With Visceral Hemangiomatosis H emangiomas ofinfancy (HOI) are the most common benign tumors of child- hood. Most HOI are soli- tary localized lesions with a relatively low risk of complications. Mul- tifocal hemangiomas, on the other hand, are as- sociated with a higher potential for concomi- tant visceral hemangio- mas. In this case series supplemented by an ex- tensive review of previ- ously reported cases, Metry et al demonstrate that large solitary segmental HOI may also be associated with extracutaneous hemangiomatosis. Evalua- tion of patients with segmental hemangiomas should be tailored to risk fac- tors and signs and symptoms that may be present. See page 591 SECTION EDITOR: ROBIN L. TRAVERS, MD Multiple facial hemangiomas present in a segmental distribution. THIS MONTH IN ARCHIVES OF DERMATOLOGY (REPRINTED) ARCH DERMATOL / VOL 140, MAY 2004 WWW.ARCHDERMATOL.COM 515 ©2004 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ by a Carnegie Mellon University User on 04/05/2021