Dermatology Nurses' Association

FOR IMMEDIATE RELEASE
December 8, 2004

Best Treatment Options for Lentigo Maligna
Lentigo maligna (LM) melanoma is a melanoma in situ on sun-damaged skin, which means it is a superficial form of melanoma localized within the epidermis, without invasion into the dermis or second layer of the skin. Its growth is generally slow, but it can become an invasive form of melanoma, so early detection and treatment is important. In the December 2004 issue of Dermatology Nursing, Leslie J. Christenson, MD, evaluates several treatment options for LM.

Dr. Christenson recommends excision by the wide-margin Mohs technique (taking at least the 5 mm recommended margin around the tumor), with confirmation of the absolute peripheral rim from permanent pathologic slides read by a dermatopathologist. Radiation therapy is also an option, especially in patients who can not tolerate surgery.

The author suggests preparing patients mentally for the possible extensiveness of their therapy. He also recommends that once patients have been diagnosed with LM, prevention of another melanoma is important. (Leslie J. Christenson, MD; Management of Lentigo Maligna; December 2004; Dermatology Nursing; www.dermatologynursing.net)

Study Evaluates Best Mattresses and Positions to Avoid Pressure Ulcers
Pressure ulcers are a major health care problem in terms of mobility, suffering, and the associated economic impact. In the December 2004 issue of Dermatology Nursing, Parivash Moody, BSN, RN, and co-authors examine the interface pressure from different types of mattresses and positions, to determine the best option for quadriplegic patients.

The authors examined the range of pressure on the body of a quadriplegic patient using two types of mattresses: pressure relieving and pressure reducing. They also studied the amount of pressure on the body in four different positions including three supine positions, with the head of the bed elevated at 45°, 60°, and 65°; and one lateral position with the head elevated at 30°.

The results of the study indicated that the 30° lateral position caused less pressure compared with the other three positions on both mattresses. The higher degree body positions rendered higher interface pressure, therefore the authors recommend the 60° and 65° positions should be avoided as much as possible.

All bedridden patients should be considered at risk of pressure ulcer development, according to the authors. They also suggest that a nursing care plan be formulated and implemented based on the patient's medical condition and duration of immobilization. (Parivash Moody, BSN, RN, Irene Gonzales, PhD, RN, CNP, Virginia Young Cureton, DrPH, RN; The Effect of Body Position and Mattress Type on Interface Pressure in Quadriplegic Adults: A Pilot Study; December 2004; Dermatology Nursing; www.dermatologynursing.net).

Treatments for Excessive Sweating
Hyperhidrosis is associated with significant psychosocial morbidity and has a dramatic impact on quality of life. It is a disease of the eccrine sweat glands that causes excessive sweating. In the December 2004 issue of Dermatology Nursing, Aamir Haider, MD, PharmD, and Nowell Solish, MD, FRCP, outline the current approaches to diagnosis and management of this disease.

Treatments can be classified into topical, oral, surgical, and nonsurgical. Of the different options available, the nonsurgical treatment, botulinum toxin, has a reported efficacy of greater than 90%. It causes the least side effects and is well-tolerated. However, the cost of the drug and need for repeated treatments may be a limitation.

According to the authors, health care professionals must be aware of the risks, benefits, and reasonable expectations of the available treatment modalities. They also suggest that with proper screening, education, and therapeutic intervention, the patients' quality of life can be enhanced. (Aamir Haider, MD, PharmD, Nowell Solish, MD, FRCP; Hyperhidrosis: An Approach to Diagnosis and Management; December 2004; Dermatology Nursing; www.dermatologynursing.net)

Dermatology Nurses to Increase Scope of Knowledge at Conference
The Dermatology Nurses' Association (DNA) will hold its 23rd Annual Convention on February 17-20, 2005, at the Hyatt Regency New Orleans, New Orleans, LA.

The ever-changing field of dermatology requires nurses to constantly broaden their knowledge base. Program planners have met this challenge by including a wide variety of education sessions on dermatologic and professional topics at all levels, from basic to advanced.

In addition to education sessions, participants will network with colleagues, attend special events, earn continuing education credits, and learn about the latest products and technologies in the exhibit hall. The complete registration brochure is available on DNA's Web site, www.dnanurse.org.