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The Propionibacterium acnes biofilm has previously been shown to exist via genomic studies and to make a biological glue which allows for adherence to follicular walls. This gylcocalyx polymer secreted by P acnes also finds its way into sebum composition where it causes the adhesiveness of keratinocytes leading to comedones. An appreciation of P acnes biofilms and secretions has implications in immunogenicity of the organism, clinical course of acne, and therapy for comedonal and inflammatory acne.

Gefitinib (Iressa), an epidermal growth factor inhibitor approved for treatment of advanced nonsmall cell lung carcinoma, is associated with an acneiform distributed folliculitis. Treatment attempts for this folliculitis have been noted in the literature, but photodocumentation of results has not been reported. We report 3 consecutive cases of gefitinib-associated folliculitis with photodocumentation of their treatment responses to combination therapy with topical metronidazole and oral tetracyclines.

Background Over-the-counter (OTC) wart-freezing therapies have appeared on the market claiming that they reproduce in-office cryotherapy. Objective We sought to determine whether these OTC home wart removal products are as cold as liquid nitrogen. Methods The coldness obtained by 3 representative commercial wart products, and liquid nitrogen, was assessed using a thermometer calibrated from –100°C to 50°C. Temperatures of the commercial wart products used were measured and compared with those obtained with liquid nitrogen. Results None of the OTC coolants were as cold as liquid nitrogen, and they did not lower temperature as quickly as liquid nitrogen. Limitations This study did not evaluate the clinical efficacy of any of the agents studied. Conclusions Despite advertising messages, OTC refrigerants do not achieve freezing equivalent to liquid nitrogen.

Biofilms are populations of microorganisms that adhere to surfaces and produce an extracellular polysaccharide, increasing resistance to standard antimicrobials. This microbiologic principle may be beneficial in understanding refractory dermatophyte infections, such as dermatophytomas of the nail. In this condition, circumscribed dense white fungal masses live within and under the nail plate. Biofilm research could lead to finding new targets for antifungal therapy, including agents that reduce attachment of microorganisms, alter microorganisms' ability to synthesize extracellular matrix, and better penetrate the extracellular matrix to kill the organism contained with the biofilm. (J Am Acad Dermatol 2002;47:629-31.)

Darier’s disease is inherited in an autosomal dominant fashion.1 Nevertheless, half of affected persons have no family history of the condition. Darier’s disease presents with scattered, greasy, keratotic papules on the face, neck, chest, back, and extremities that coalesce forming plaques. It is exacerbated by heat and sweating, and usually worsened by exposure to sunlight.1 The cause of the distorted keratinization is dissolution of desmosomal plaque proteins, specifically, desmoplakin I and II, plakoglobin, and desmoglein.2 The result of this defect is a deficiency in the tonofilament/desmosome attachment, leading to tonofilament clumping and vesicle formation. Because oral isotretinoin is effective in this condition,3 the new topical acetylenic retinoid tazarotene was tried in a patient.