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Skin cancer rates have been steadily increasing over the last 20 years despite persistent efforts to educate the public on skin cancer prevention and sun safety. Adolescents and young adults are an especially important demographic to reach, as increased UV exposure during these years leads to greatly increased risks of developing skin cancer. Our survey aims to investigate the attitudes and behaviors regarding sun protection and tanning among adolescents and young adults (age range, 13-27 years).

Relapsing polychondritis (RP) is a rare rheumatologic disorder in which recurrent episodes of inflammation result in destruction of cartilage of the ears and nose. The joints, eyes, audio-vestibular system, heart valves, respiratory tract, kidneys, and skin can also be involved. Skin involvement is most frequently linked to concomitant myelodysplastic syndrome and has rarely been associated with systemic lupus erythematosus. A 47-year-old woman presented with violaceous, indurated, tender plaques on the bilateral cartilaginous ears with sparing of the lobes, consistent with RP. Further investigations revealed positive ANA and anti-Smith antibody, oral ulcers, a photo-distributed skin eruption, and biopsy-proven lupus nephritis, leading to a second concomitant diagnosis of systemic lupus erythematosus (SLE). The diagnosis of SLE associated with RP was made and the patient was started on oral prednisone and hydroxychloroquine. This is a rare report of SLE associated with RP. It is unclear whether RP occurring in patients with SLE represents another clinical manifestation of SLE or a coexisting disease. However, a significant ANA titer in a patient with RP strongly suggests the presence of an associated autoimmune disorder. If immunologic abnormalities usually found in SLE are detected in patients with RP, it is important to monitor patients for the development of other manifestations of SLE.

We describe a patient with cutaneous Crohn's disease with extensive cutaneous ulcerations preceding the diagnosis of gastrointestinal Crohn's. The cutaneous lesions responded to mesalamine and prednisone. The patient has been maintained on a regimen of mesalamine alone without recurrence. We discuss available forms of mesalamine and their function in cutaneous disease. (J Am Acad Dermatol 1999;41:476-9.)

Rates of primary and secondary syphilis have increased in the past decade, warranting renewed attention to the diagnosis and treatment of this disease. Men who have sex with men are particularly affected; however, increases in infection rates have also been noted in women, as well as in all age groups and ethnicities. Physicians need to vigilantly screen high-risk patients. The concurrent rise in congenital syphilis also requires special attention and reemphasizes the need for continued early prenatal care and syphilis screening for all pregnant women. Syphilis infection in patients coinfected with human immunodeficiency virus has also become more common. New experimental diagnostic approaches, including using the B cell chemoattractant chemokine (CXC motif) ligand 13 as a cerebrospinal fluid marker, may help identify suspected neurosyphilis cases. Additionally, point-of-care immunochromatographic strip testing has been suggested for screening high-risk populations in developing countries. Nontreponemal screening tests followed by treponemal confirmatory tests continue to be standard diagnostics; however, interpreting false-negative and false-positive test results, and identifying serofast reactions, can be challenging. Although doxycycline, tetracycline, ceftriaxone, and azithromycin have been used to successfully treat syphilis, penicillin remains the drug of choice in all stages of infection and is the therapy recommended by the Centers for Disease Control and Prevention. Close follow-up is necessary to ensure treatment success.

The October 2001 domestic anthrax attacks affected 22 people, resulting in 5 fatalities. The added global terrorist threats have created an increasing need for homeland protection, as well as protection of our widely deployed forces battling terrorism. It is now relevant for physicians to be familiar with both clinical anthrax and adverse vaccine-related events associated with the resumption of the anthrax vaccine program. Dermatologists played a lead role in the initial response to the anthrax attack. We must be the lead providers most familiar with the cutaneous reactions that may be seen with the preventive vaccination. This article reviews the latest recommended evaluation and management of anthrax vaccine adverse events.

Background Few published articles focus on undergraduate dermatology education. Objective To quantify the amount and type of dermatology instruction for medical students and to rank specific diseases by the expectations of learners. Methods Electronic surveys were sent via e-mail to 109 dermatology residency programs as well as to 33 medical schools without dermatology programs. Results Responses were received from 64% of dermatology residency programs. Half of the responding institutions require 10 or fewer hours of dermatology instruction, and 8% require no dermatology instruction. Seventy-five percent or more of the responding dermatologists expected medical students to learn to diagnose or treat 33 skin diseases after completing a clinical dermatology rotation. Limitations Surveys were sent only to academic institutions. Conclusions Dermatology educators expect medical students to learn to diagnose or treat common skin diseases, but little time is designated for this in most medical schools. The aggregate opinions of dermatology educators may be used to prioritize future curricula.