Actinic Keratosis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

ACTINIC KERATOSIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J ...

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ACTINIC KERATOSIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Actinic Keratosis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00016-4 1. Actinic Keratosis-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on actinic keratosis. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON ACTINIC KERATOSIS ................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Actinic Keratosis........................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 5 CHAPTER 2. PATENTS ON ACTINIC KERATOSIS .............................................................................. 23 Overview...................................................................................................................................... 23 Patents on Actinic Keratosis........................................................................................................ 23 Patent Applications on Actinic Keratosis .................................................................................... 29 Keeping Current .......................................................................................................................... 32 CHAPTER 3. BOOKS ON ACTINIC KERATOSIS ................................................................................. 35 Overview...................................................................................................................................... 35 Book Summaries: Federal Agencies.............................................................................................. 35 Chapters on Actinic Keratosis...................................................................................................... 36 CHAPTER 4. PERIODICALS AND NEWS ON ACTINIC KERATOSIS .................................................... 39 Overview...................................................................................................................................... 39 News Services and Press Releases................................................................................................ 39 Academic Periodicals covering Actinic Keratosis ........................................................................ 41 CHAPTER 5. RESEARCHING MEDICATIONS .................................................................................... 43 Overview...................................................................................................................................... 43 U.S. Pharmacopeia....................................................................................................................... 43 Commercial Databases ................................................................................................................. 44 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 47 Overview...................................................................................................................................... 47 NIH Guidelines............................................................................................................................ 47 NIH Databases............................................................................................................................. 49 Other Commercial Databases....................................................................................................... 51 APPENDIX B. PATIENT RESOURCES ................................................................................................. 53 Overview...................................................................................................................................... 53 Patient Guideline Sources............................................................................................................ 53 Finding Associations.................................................................................................................... 56 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 59 Overview...................................................................................................................................... 59 Preparation................................................................................................................................... 59 Finding a Local Medical Library.................................................................................................. 59 Medical Libraries in the U.S. and Canada ................................................................................... 59 ONLINE GLOSSARIES.................................................................................................................. 65 Online Dictionary Directories ..................................................................................................... 66 ACTINIC KERATOSIS DICTIONARY....................................................................................... 67 INDEX ................................................................................................................................................ 97

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with actinic keratosis is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about actinic keratosis, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to actinic keratosis, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on actinic keratosis. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to actinic keratosis, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on actinic keratosis. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON ACTINIC KERATOSIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on actinic keratosis.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and actinic keratosis, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “actinic keratosis” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Chemical Peel as a Treatment for Skin Damage From Excessive Sun Exposure Source: Dermatology Nursing. 9(2):99-104; April 1997. Summary: This journal article for health professionals discusses the use of chemical peeling for treating skin disorders resulting from excessive sun exposure, including photoaging skin, actinic keratosis, melasma, and other conditions. Types of acids used in chemical peels are described, including glycolic acid, trichloracetic acid, and phenol. The role of the nurse in the chemical peel procedure is discussed, and the steps involved in performing a chemical peel are described. 7 references, 7 figures, and 2 tables.

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Skin Cancer Primer for Primary Care, A Source: JAAPA: Journal of the American Academy of Physician Assistants. 14(4): 1314,16,21,22,25-26. April 2001. Summary: This journal article provides health professionals with information on the classification, diagnosis, and treatment of skin cancers. Skin cancers can be divided into nonmelanoma and melanoma. The nonmelanoma group comprises basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Nonmelanoma cancers are highly treatable and rarely metastasize. Melanoma has a much higher mortality rate than nonmelanoma skin cancers. The number one risk factor for the development of premalignant and malignant skin neoplasms is sun exposure. Chronic sun exposure places a person at risk for actinic keratoses, BCC, and SCC. Episodic sunburns, particularly in childhood, increase the risk of malignant melanoma. Other risk factors include skin complexion, tolerance to sun exposure, ethnicity, degree of freckling, geographic location, history of malignant or premalignant skin lesions, exposure to ionizing radiation, chronic skin irritation, and immunosuppression. BBC is the most common skin cancer, and BBC lesions are typically located on the face and dorsum of the hands and forearms. BBC can be classified as nodulo ulcerative, superficial, morphealike, and pigmented. Definitive diagnosis requires a shave or full thickness punch biopsy. Therapeutic options for BBC depend on various factors, and they include electrodesiccation and curettage; Mohs' micrographic surgery; cryotherapy; and coned down, fractionated radiation therapy. SCC is the second most common cutaneous malignancy, occurring most frequently on sun exposed areas of the skin. The differential diagnosis includes actinic keratosis, Bowen's disease, keratoacanthoma, amelanotic melanoma, BCC, and verrucae. SCC is diagnosed with a full thickness punch biopsy. Therapeutic options include cryotherapy, excision with Mohs' micrographic surgery, and topical chemotherapy. Melanoma is a malignancy of melanocytes and nevus cells that appears clinically as a mole. The disease is evaluated on the basis of depth of invasion into the skin and thickness. A changing nevus is the most important sign or symptom for melanoma. Types include superficial spreading melanoma, nodulo ulcerative melanoma, lentigo maligna melanoma, and acral lentiginous melanoma. Excision with narrow margins is the treatment of choice. 3 figures and 14 references.

Federally Funded Research on Actinic Keratosis The U.S. Government supports a variety of research studies relating to actinic keratosis. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to actinic keratosis.

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore actinic keratosis.

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with actinic keratosis, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “actinic keratosis” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for actinic keratosis (hyperlinks lead to article summaries): •

A comparison of photodynamic therapy using topical methyl aminolevulinate (Metvix) with single cycle cryotherapy in patients with actinic keratosis: a prospective, randomized study. Author(s): Freeman M, Vinciullo C, Francis D, Spelman L, Nguyen R, Fergin P, Thai KE, Murrell D, Weightman W, Anderson C, Reid C, Watson A, Foley P. Source: The Journal of Dermatological Treatment. 2003 June; 14(2): 99-106. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12775317

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A pharmacokinetic evaluation of 0.5% and 5% fluorouracil topical cream in patients with actinic keratosis. Author(s): Levy S, Furst K, Chern W. Source: Clinical Therapeutics. 2001 June; 23(6): 908-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11440290

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A retrospective study of the effect of long-term topical application of retinaldehyde (0.05%) on the development of actinic keratosis. Author(s): Campanelli A, Naldi L. Source: Dermatology (Basel, Switzerland). 2002; 205(2): 146-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12218230

3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A survey of office visits for actinic keratosis as reported by NAMCS, 1990-1999. National Ambulatory Medical Care Survey. Author(s): Gupta AK, Cooper EA, Feldman SR, Fleischer AB Jr. Source: Cutis; Cutaneous Medicine for the Practitioner. 2002 August; 70(2 Suppl): 8-13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12353680

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Acridine orange-DNA complex in actinic keratosis. Author(s): Kumakiri M, Hashimoto K. Source: Journal of the National Cancer Institute. 1977 September; 59(3): 839-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=70537

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Actinic keratosis and dysplasia of the conjunctiva: a clinicopathological study of 45 cases. Author(s): Mauriello JA Jr, Napolitano J, McLean I. Source: Can J Ophthalmol. 1995 October; 30(6): 312-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8574978

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Actinic keratosis and premalignant skin damage. Author(s): Basler DE. Source: Dermatology Nursing / Dermatology Nurses' Association. 1991 February; 3(1): 37-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1825280

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Actinic keratosis and squamous cell carcinoma. Author(s): Kuflik AS, Schwartz RA. Source: American Family Physician. 1994 March; 49(4): 817-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8116516

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Actinic keratosis and telangiectasia. Author(s): Frankel EB. Source: Archives of Dermatology. 1972 February; 105(2): 298. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5060883

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Actinic keratosis induced by a sunbed. Author(s): Cox NH. Source: Bmj (Clinical Research Ed.). 1994 April 9; 308(6934): 977-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8173409

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Actinic keratosis induced by use of sunbed. Author(s): Speight EL, Dahl MG, Farr PM. Source: Bmj (Clinical Research Ed.). 1994 February 5; 308(6925): 415. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8124162

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Actinic keratosis is squamous cell carcinoma. Author(s): Lober BA, Lober CW, Accola J. Source: Journal of the American Academy of Dermatology. 2000 November; 43(5 Pt 1): 881-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11050603

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Actinic keratosis is squamous cell carcinoma. Author(s): Lober BA, Lober CW. Source: Southern Medical Journal. 2000 July; 93(7): 650-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10923948

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Actinic keratosis treated with an immune response modifier: a case report of six patients. Author(s): Bianchi L, Campione E, Marulli GC, Costanzo A, Chimenti S. Source: Clinical and Experimental Dermatology. 2003 November; 28 Suppl 1: 39-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616813

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Actinic keratosis. Author(s): Poulson TC. Source: Gerodontics. 1986 February; 2(1): 1-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3457743

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Actinic keratosis. A premalignant skin lesion. Author(s): Marks VJ. Source: Otolaryngologic Clinics of North America. 1993 February; 26(1): 23-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8433840

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Actinic keratosis. Current treatment options. Author(s): Jeffes EW 3rd, Tang EH. Source: American Journal of Clinical Dermatology. 2000 May-June; 1(3): 167-79. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11702298

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Actinic keratosis: a case of sun damage in the tropics. Author(s): Olasode OA, Onayemi O, Olasode BJ, Odeanmi WO. Source: Cent Afr J Med. 1997 June; 43(6): 177-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9431747

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Actinic keratosis: epidemiology and progression to squamous cell carcinoma. Author(s): Lebwohl M. Source: The British Journal of Dermatology. 2003 November; 149 Suppl 66: 31-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616345

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Actinic keratosis: preventable and treatable like other precancerous and cancerous skin lesions. Author(s): Nicol NH. Source: Plastic Surgical Nursing : Official Journal of the American Society of Plastic and Reconstructive Surgical Nurses. 1989 Summer; 9(2): 49-55. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2675146

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Actinic keratosis: time to call a spade a spade. Author(s): Evans C, Cockerell CJ. Source: Southern Medical Journal. 2000 July; 93(7): 734-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10923970

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Actinic keratosis--a histoenzymological study. Author(s): Taranu T, Caruntu ID, Taranu T, Petreus T. Source: Rev Med Chir Soc Med Nat Iasi. 2001 July-September; 105(3): 514-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12092184

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Actinic keratosis--the advent of fluorouracil. Author(s): Anderson L. Source: J Kans Med Soc. 1973 August; 74(8): 306-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4726722

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ALA/PDT in the treatment of actinic keratosis: spot versus confluent therapy. Author(s): Goldman M, Atkin D. Source: Journal of Cosmetic and Laser Therapy : Official Publication of the European Society for Laser Dermatology. 2003 June; 5(2): 107-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12850802

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An actinic keratosis is neither malignant nor premalignant: it is an initiated tumor. Author(s): Person JR. Source: Journal of the American Academy of Dermatology. 2003 April; 48(4): 637-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12664040

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Analysis of the p53 gene in human precancerous actinic keratosis lesions and squamous cell cancers. Author(s): Nelson MA, Einspahr JG, Alberts DS, Balfour CA, Wymer JA, Welch KL, Salasche SJ, Bangert JL, Grogan TM, Bozzo PO. Source: Cancer Letters. 1994 September 30; 85(1): 23-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7923098

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Aneuploidy in actinic keratosis and Bowen's disease--increased risk for invasive squamous cell carcinoma? Author(s): Biesterfeld S, Pennings K, Grussendorf-Conen EI, Bocking A. Source: The British Journal of Dermatology. 1995 October; 133(4): 557-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7577583

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Association of nonmelanoma skin cancer and actinic keratosis with cumulative solar ultraviolet exposure in Maryland watermen. Author(s): Vitasa BC, Taylor HR, Strickland PT, Rosenthal FS, West S, Abbey H, Ng SK, Munoz B, Emmett EA. Source: Cancer. 1990 June 15; 65(12): 2811-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2340474

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Benign lymphangioendothelioma manifested clinically as actinic keratosis. Author(s): Yiannias JA, Winkelmann RK. Source: Cutis; Cutaneous Medicine for the Practitioner. 2001 January; 67(1): 29-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11204600

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Ber-EP4-positive phenotype differentiates actinic keratosis from superficial basal cell carcinoma. Author(s): Tope WD, Nowfar-Rad M, Kist DA. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2000 May; 26(5): 415-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10816226

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Case 10. Actinic keratosis. Author(s): Haring JI. Source: Rdh. 1998 October; 18(10): 16, 74. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10825914

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Characterization of a new type of human papillomavirus (HPV) related to HPV5 from a case of actinic keratosis. Author(s): Kawashima M, Favre M, Jablonska S, Obalek S, Orth G. Source: Virology. 1986 October 30; 154(2): 389-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3020786

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Clinical effect of imiquimod 5% cream in the treatment of actinic keratosis. Author(s): Persaud AN, Shamuelova E, Sherer D, Lou W, Singer G, Cervera C, Lamba S, Lebwohl MG. Source: Journal of the American Academy of Dermatology. 2002 October; 47(4): 553-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12271300

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Comparative histochemical study of Bowen's disease and actinic keratosis: preserved normal basal cells in Bowen's disease. Author(s): Ishida H, Kumakiri M, Ueda K, Lao LM, Yanagihara M, Asamoto K, Imamura Y, Noriki S, Fukuda M. Source: Eur J Histochem. 2001; 45(2): 177-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11512639

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Comparison of the microvasculature of basal cell carcinoma and actinic keratosis using intravital microscopy and immunohistochemistry. Author(s): Newell B, Bedlow AJ, Cliff S, Drysdale SB, Stanton AW, Mortimer PS. Source: The British Journal of Dermatology. 2003 July; 149(1): 105-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12890202

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Cutaneous vitamin A levels in seborrheic keratosis, actinic keratosis, and basal cell carcinoma. Author(s): Rollman O, Vahlquist A. Source: Archives of Dermatological Research. 1981; 270(2): 193-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6454396

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Cyclin D and retinoblastoma gene product expression in actinic keratosis and cutaneous squamous cell carcinoma in relation to p53 expression. Author(s): Bito T, Ueda M, Ahmed NU, Nagano T, Ichihashi M. Source: Journal of Cutaneous Pathology. 1995 October; 22(5): 427-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8594075

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Cycloheximide as an alternative to the use of fluorouracil for actinic keratosis. Author(s): Milstein HG. Source: Archives of Dermatology. 1980 June; 116(6): 622. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7377799

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Delayed wound healing after three different treatments for widespread actinic keratosis on the atrophic bald scalp. Author(s): Quaedvlieg PJ, Ostertag JU, Krekels GA, Neumann HA. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2003 October; 29(10): 1052-6; Discussion 1056. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12974704

Studies

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DNA repair deficiency in lymphocytes from patients with actinic keratosis. Author(s): Abo-Darub JM, Mackie R, Pitts JD. Source: Bulletin Du Cancer. 1978; 65(3): 357-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=719188

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DNA repair in cells from patients with actinic keratosis. Author(s): Abo-Darub JM, MacKie R, Pitts JD. Source: The Journal of Investigative Dermatology. 1983 April; 80(4): 241-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6833781

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DNA repair synthesis in fibroblast strains from patients with actinic keratosis, squamous cell carcinoma, basal cell carcinoma, or malignant melanoma after treatment with ultraviolet light, N-acetoxy-2-acetyl-aminofluorene, methyl methanesulfonate, and N-methyl-N-nitrosourea. Author(s): Thielmann HW, Edler L, Burkhardt MR, Jung EG. Source: Journal of Cancer Research and Clinical Oncology. 1987; 113(2): 171-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3558453

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DNA-repair after UV-irradiation in skin fibroblasts from patients with actinic keratosis. Author(s): Sbano E, Andreassi L, Fimiani M, Valentino A, Baiocchi R. Source: Archives of Dermatological Research. 1978 June 29; 262(1): 55-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=686819

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Effect of a low-fat diet on the incidence of actinic keratosis. Author(s): Black HS, Herd JA, Goldberg LH, Wolf JE Jr, Thornby JI, Rosen T, Bruce S, Tschen JA, Foreyt JP, Scott LW, et al. Source: The New England Journal of Medicine. 1994 May 5; 330(18): 1272-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8145782

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Effect of topical 5-fluorouracil treatment on actinic keratosis: a light and electron microscopic study. Author(s): Hodge SJ, Schrodt GR, Owen LG. Source: Journal of Cutaneous Pathology. 1974; 1(6): 238-48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4470728

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Effective treatment of actinic keratosis with 0.5% fluorouracil cream for 1, 2, or 4 weeks. Author(s): Weiss J, Menter A, Hevia O, Jones T, Ling M, Rist T, Roberts J, Shavin JS, Sklar J, Webster G, Connolly M, Furst K, Levy S. Source: Cutis; Cutaneous Medicine for the Practitioner. 2002 August; 70(2 Suppl): 22-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12353677

12

Actinic Keratosis

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Etretinate in treatment of actinic keratosis. A double-blind crossover study. Author(s): Moriarty M, Dunn J, Darragh A, Lambe R, Brick I. Source: Lancet. 1982 February 13; 1(8268): 364-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6120350

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Evaluation of 5-fluorouracil in the treatment of actinic keratosis of the lip. Author(s): Warnock GR, Fuller RP Jr, Pelleu GB Jr. Source: Oral Surg Oral Med Oral Pathol. 1981 November; 52(5): 501-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6946379

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Evaluation of proliferating cell nuclear antigen as a surrogate end point biomarker in actinic keratosis and adjacent, normal-appearing, and non-sun-exposed human skin samples. Author(s): Einspahr J, Alberts DS, Aickin M, Welch K, Bozzo P, Levine N, Grogan T. Source: Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. 1996 May; 5(5): 343-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9162299

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Evaluation of the efficacy and tolerability of 0.5% fluorouracil cream and 5% fluorouracil cream applied to each side of the face in patients with actinic keratosis. Author(s): Loven K, Stein L, Furst K, Levy S. Source: Clinical Therapeutics. 2002 June; 24(6): 990-1000. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12117087

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Expression of matrix metalloproteinase-1, -2 and -3 in squamous cell carcinoma and actinic keratosis. Author(s): Tsukifuji R, Tagawa K, Hatamochi A, Shinkai H. Source: British Journal of Cancer. 1999 June; 80(7): 1087-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10362121

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Expression of p53 protein in actinic keratosis, adjacent, normal-appearing, and nonsun-exposed human skin. Author(s): Einspahr J, Alberts DS, Aickin M, Welch K, Bozzo P, Grogan T, Nelson M. Source: Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. 1997 August; 6(8): 583-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9264270

Studies

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Expression of p53, bcl-2 and growth hormone receptor in actinic keratosis, hypertrophic type. Author(s): Stanimirovic A, Cupic H, Bosnjak B, Kruslin B, Belicza M. Source: Archives of Dermatological Research. 2003 July; 295(3): 102-8. Epub 2003 May 20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12756585

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Frequency of pre-existing actinic keratosis in cutaneous squamous cell carcinoma. Author(s): Mittelbronn MA, Mullins DL, Ramos-Caro FA, Flowers FP. Source: International Journal of Dermatology. 1998 September; 37(9): 677-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9762818

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From actinic keratosis to squamous cell carcinoma. Author(s): Ortonne JP. Source: The British Journal of Dermatology. 2002 April; 146 Suppl 61: 20-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11966728

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From sunlight to actinic keratosis to squamous cell carcinoma. Author(s): Cohn BA. Source: Journal of the American Academy of Dermatology. 2000 January; 42(1 Pt 1): 1434. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10607337

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Health economic evaluation of non-melanoma skin cancer and actinic keratosis. Author(s): Higashi MK, Veenstra DL, Langley PC. Source: Pharmacoeconomics. 2004; 22(2): 83-94. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14731050

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Histopathology of incipient intraepidermal squamous cell carcinoma ("actinic keratosis"). Author(s): Cockerell CJ. Source: Journal of the American Academy of Dermatology. 2000 January; 42(1 Pt 2): 117. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10607351

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Human papillomavirus infection in actinic keratosis and bowen's disease: comparative study with expression of cell-cycle regulatory proteins p21(Waf1/Cip1), p53, PCNA, Ki-67, and Bcl-2 in positive and negative lesions. Author(s): Mitsuishi T, Kawana S, Kato T, Kawashima M. Source: Human Pathology. 2003 September; 34(9): 886-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14562284

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Hypertrophic actinic keratosis. Author(s): Billano RA, Little WP. Source: Journal of the American Academy of Dermatology. 1982 October; 7(4): 484-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7142459

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Immunohistochemical staining for desmogleins 1 and 2 in keratinocytic neoplasms with squamous phenotype: actinic keratosis, keratoacanthoma and squamous cell carcinoma of the skin. Author(s): Krunic AL, Garrod DR, Madani S, Buchanan MD, Clark RE. Source: British Journal of Cancer. 1998 April; 77(8): 1275-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9579833

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Immunohistochemistry detects differences between lichen planus-like keratosis, lichen planus, and lichenoid actinic keratosis. Author(s): Prieto VG, Casal M, McNutt NS. Source: Journal of Cutaneous Pathology. 1993 April; 20(2): 143-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8320359

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Incidence of actinic keratosis of Japanese in Kasai City, Hyogo. Author(s): Suzuki T, Ueda M, Naruse K, Nagano T, Harada S, Imaizumi K, Watanabe S, Ichihashi M. Source: Journal of Dermatological Science. 1997 November; 16(1): 74-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9438911

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Induction of cancer, actinic keratosis, and specific p53 mutations by UVB light in human skin maintained in severe combined immunodeficient mice. Author(s): Nomura T, Nakajima H, Hongyo T, Taniguchi E, Fukuda K, Li LY, Kurooka M, Sutoh K, Hande PM, Kawaguchi T, Ueda M, Takatera H. Source: Cancer Research. 1997 June 1; 57(11): 2081-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9187098

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Inflammation of actinic keratosis caused by systemic chemotherapy--2'deoxycoformycin. Author(s): Camisa C. Source: Journal of the American Academy of Dermatology. 1988 October; 19(4): 758. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3263402

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Inflammation of actinic keratosis secondary to systemic 5-fluorouracil. Author(s): Torre D. Source: Archives of Dermatology. 1968 July; 98(1): 95-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5657401

Studies

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Inhibition and recovery of DNA synthesis in PHA-stimulated u.v.-irradiated lymphocytes from patients with actinic keratosis. Author(s): Abo-Darub JM, Mackie R, Pitts JD. Source: Bioscience Reports. 1983 March; 3(3): 293-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6860788

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Invasive cutaneous squamous cell carcinoma associated with actinic keratosis: a case with orbital invasion and meningeal infiltration. Author(s): Schwarze HP, Loche F, Gorguet MC, Kuchta J, Bazex J. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1999 July; 25(7): 587-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10469120

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Is imiquimod effective and safe for actinic keratosis? Author(s): Walker JK, Koenig C. Source: The Journal of Family Practice. 2003 March; 52(3): 184-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12620165

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Lamin expression in normal human skin, actinic keratosis, squamous cell carcinoma and basal cell carcinoma. Author(s): Tilli CM, Ramaekers FC, Broers JL, Hutchison CJ, Neumann HA. Source: The British Journal of Dermatology. 2003 January; 148(1): 102-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12534602

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Large pigmented actinic keratosis of the eyelid. Author(s): Salama SD, Margo CE. Source: Archives of Ophthalmology. 1995 August; 113(8): 977-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7639670

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LAV694, a new antiproliferative agent showing improved skin tolerability vs. clinical standards for the treatment of actinic keratosis. Author(s): Medina J, Picarles V, Greiner B, Elsaesser C, Kolopp M, Mahl A, Roman D, Vogel B, Nussbaumer P, Winiski A, Meingassner J, Fraissinette Ade B. Source: Biochemical Pharmacology. 2003 November 15; 66(10): 1885-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14599546

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Levulan: the first approved topical photosensitizer for the treatment of actinic keratosis. Author(s): Jeffes EW. Source: The Journal of Dermatological Treatment. 2002; 13 Suppl 1: S19-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12060513

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Lichenoid actinic keratosis. Author(s): Hirsch P, Marmelzat WL. Source: Dermatol Int. 1967 April-June; 6(2): 101-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5585742

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Lipid profile in actinic keratosis and basal cell carcinoma. Author(s): Vural P, Canbaz M, Sekcuki D, Murat A. Source: International Journal of Dermatology. 1999 June; 38(6): 439-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10397583

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Loss of heterozygosity in actinic keratosis, squamous cell carcinoma and sun-exposed normal-appearing skin in Japanese: difference between Japanese and Caucasians. Author(s): Kushida Y, Miki H, Ohmori M. Source: Cancer Letters. 1999 June 1; 140(1-2): 169-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10403556

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Metastatic cutaneous squamous cell carcinoma derived from actinic keratosis. Author(s): Dinehart SM, Nelson-Adesokan P, Cockerell C, Russell S, Brown R. Source: Cancer. 1997 March 1; 79(5): 920-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9041154

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Multiple actinic keratosis and skin tumors secondary to hydroxyurea treatment. Author(s): Salmon-Ehr V, Grosieux C, Potron G, Kalis B. Source: Dermatology (Basel, Switzerland). 1998; 196(2): 274. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9568428

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Nitric oxide and endothelin-1,2 in actinic keratosis and basal cell carcinoma: changes in nitric oxide/endothelin ratio. Author(s): Vural P, Erzengin D, Canbaz M, Selcuki D. Source: International Journal of Dermatology. 2001 November; 40(11): 704-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11737437

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No evidence of human papillomavirus DNA in actinic keratosis. Author(s): Lu S, Syrjanen K, Havu VK, Syrjanen. Source: Archives of Dermatological Research. 1995; 287(7): 649-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8534128

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p16INK4a expression in actinic keratosis and Bowen's disease. Author(s): Salama ME, Mahmood MN, Qureshi HS, Ma C, Zarbo RJ, Ormsby AH. Source: The British Journal of Dermatology. 2003 November; 149(5): 1006-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14632806

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P27 and mib1 expression in actinic keratosis, Bowen disease, and squamous cell carcinoma. Author(s): Oh CW, Penneys N. Source: The American Journal of Dermatopathology. 2004 February; 26(1): 22-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14726819

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Pagetoid variant of actinic keratosis with or without squamous cell carcinoma of sunexposed skin: a lesion simulating extramammary Paget's disease. Author(s): Mai KT, Alhalouly T, Landry D, Stinson WA, Perkins DG, Yazdi HM. Source: Histopathology. 2002 October; 41(4): 331-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12383215

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Photodynamic therapy for actinic keratosis followed by 5-fluorouracil reaction. Author(s): Marcus L. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2003 October; 29(10): 1061-4; Discussion 1064-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12974706

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Photodynamic therapy of actinic keratosis with topical 5-aminolevulinic acid. A pilot dose-ranging study. Author(s): Jeffes EW, McCullough JL, Weinstein GD, Fergin PE, Nelson JS, Shull TF, Simpson KR, Bukaty LM, Hoffman WL, Fong NL. Source: Archives of Dermatology. 1997 June; 133(6): 727-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9197826

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Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: A prospective, randomized study. Author(s): Szeimies RM, Karrer S, Radakovic-Fijan S, Tanew A, Calzavara-Pinton PG, Zane C, Sidoroff A, Hempel M, Ulrich J, Proebstle T, Meffert H, Mulder M, Salomon D, Dittmar HC, Bauer JW, Kernland K, Braathen L. Source: Journal of the American Academy of Dermatology. 2002 August; 47(2): 258-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12140473

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Photodynamic therapy with topical methyl aminolevulinate for actinic keratosis: results of a prospective randomized multicenter trial. Author(s): Pariser DM, Lowe NJ, Stewart DM, Jarratt MT, Lucky AW, Pariser RJ, Yamauchi PS. Source: Journal of the American Academy of Dermatology. 2003 February; 48(2): 227-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12582393

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Photodynamic therapy with violet light and topical 6-aminolaevulinic acid in the treatment of actinic keratosis, Bowen's disease and basal cell carcinoma. Author(s): Dijkstra AT, Majoie IM, van Dongen JW, van Weelden H, van Vloten WA. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2001 November; 15(6): 550-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11843215

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Plasma antioxidant defense in actinic keratosis and basal cell carcinoma. Author(s): Vural P, Canbaz M, Selcuki D. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 1999 September; 13(2): 96-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10568487

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Prevalence of actinic keratosis in Japan. Author(s): Naruse K, Ueda M, Nagano T, Suzuki T, Harada S, Imaizumi K, Watanabe S, Ichihashi M. Source: Journal of Dermatological Science. 1997 September; 15(3): 183-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9302646

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Prevalence of solar damage and actinic keratosis in a Merseyside population. Author(s): Marks R. Source: The British Journal of Dermatology. 2001 February; 144(2): 437-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11251601

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Prevalence of solar damage and actinic keratosis in a Merseyside population. Author(s): Memon AA, Tomenson JA, Bothwell J, Friedmann PS. Source: The British Journal of Dermatology. 2000 June; 142(6): 1154-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10848739

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Progression of actinic keratosis to squamous cell carcinoma of the skin correlates with deletion of the 9p21 region encoding the p16(INK4a) tumor suppressor. Author(s): Mortier L, Marchetti P, Delaporte E, Martin de Lassalle E, Thomas P, Piette F, Formstecher P, Polakowska R, Danze PM. Source: Cancer Letters. 2002 February 25; 176(2): 205-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11804749

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Proliferative actinic keratosis. Author(s): Goldberg LH, Joseph AK, Tschen JA. Source: International Journal of Dermatology. 1994 May; 33(5): 341-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8039973

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Proliferative actinic keratosis: three representative cases. Author(s): Goldberg LH, Chang JR, Baer SC, Schmidt JD. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 2000 January; 26(1): 65-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10632689

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Pruritic rash with actinic keratosis and impending exfoliation in a patient with hypertension managed with minoxidil. Author(s): Ackerman BH, Townsend ME, Golden W, Bryan AB. Source: Drug Intell Clin Pharm. 1988 September; 22(9): 702-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2975213

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Quantitative assessment of Langerhans cells in actinic keratosis, Bowen's disease, keratoacanthoma, squamous cell carcinoma and basal cell carcinoma. Author(s): McArdle JP, Knight BA, Halliday GM, Muller HK, Rowden G. Source: Pathology. 1986 April; 18(2): 212-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3763243

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Radiation therapy for extensive actinic keratosis. Author(s): Barta U, Grafe T, Wollina U. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2000 July; 14(4): 293-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11204519

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Randomized trial evaluating a new 0.5% fluorouracil formulation demonstrates efficacy after 1-, 2-, or 4-week treatment in patients with actinic keratosis. Author(s): Jorizzo J, Stewart D, Bucko A, Davis SA, Espy P, Hino P, Rodriguez D, Savin R, Stough D, Furst K, Connolly M, Levy S. Source: Cutis; Cutaneous Medicine for the Practitioner. 2002 December; 70(6): 335-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12502122

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S100A protein expression in the distinction between lentigo maligna and pigmented actinic keratosis. Author(s): Ribe A, McNutt NS. Source: The American Journal of Dermatopathology. 2003 April; 25(2): 93-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12652189

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Sebaceous carcinoma arising on actinic keratosis. Author(s): Ansai S, Mihara I. Source: European Journal of Dermatology : Ejd. 2000 July-August; 10(5): 385-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10882948

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Secondary localized cutaneous amyloidosis associated with actinic keratosis. Author(s): Hashimoto K, King LE Jr. Source: The Journal of Investigative Dermatology. 1973 November; 61(5): 293-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4749463

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Selective inflammatory effect of systemic fluorouracil in actinic keratosis. Author(s): Nabai H, Mohindra R, Mehregan D. Source: Cutis; Cutaneous Medicine for the Practitioner. 1999 July; 64(1): 43-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10431671

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Selective loss of chondroitin 6-sulphate from basement membrane during progression from actinic keratosis to squamous cell carcinoma. Author(s): Kazama T, Fujiwara K, Ito M. Source: Archives of Dermatological Research. 1994; 286(2): 130-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8154926

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Simulation of solar lentigo by spreading pigmented actinic keratosis. Author(s): Klinker M, Jonsson N. Source: Acta Dermato-Venereologica. 1994 September; 74(5): 406-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7817686

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Spreading pigmented actinic keratosis. Author(s): Subrt P, Jorizzo JL, Apisarnthanarax P, Head ES, Smith EB. Source: Journal of the American Academy of Dermatology. 1983 January; 8(1): 63-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6826809

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Spreading pigmented actinic keratosis. An electron microscopic study. Author(s): Dinehart SM, Sanchez RL. Source: Archives of Dermatology. 1988 May; 124(5): 680-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2452605

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Standardized AgNOR analysis in actinic keratosis. Author(s): Tuccari G, Giuffre G, Catalano A, Lentini M, Batolo D. Source: The American Journal of Dermatopathology. 2001 October; 23(5): 407-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11801772

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Successful treatment of actinic keratosis with imiquimod cream 5%: a report of six cases. Author(s): Stockfleth E, Meyer T, Benninghoff B, Christophers E. Source: The British Journal of Dermatology. 2001 May; 144(5): 1050-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11359396

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Summary of actinic keratosis studies with imiquimod 5% cream. Author(s): Tran H, Chen K, Shumack S. Source: The British Journal of Dermatology. 2003 November; 149 Suppl 66: 37-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616347

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Testing your diagnostic skills (#53). Case 1: Cheilitis glandularis apostematosa. Actinic keratosis (cheilitis). Author(s): Weeks G. Source: Todays Fda. 2001 August; 13(8): 20, 23. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11545062

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The actinic keratosis. A perspective and update. Author(s): Schwartz RA. Source: Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]. 1997 November; 23(11): 1009-19; Quiz 1020-1. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9391557

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The expression of placental-type glutathione S-transferase (GST-pi) in human cutaneous carcinoma in situ, that is, actinic keratosis and Bowen's disease, compared with normal human skin. Author(s): Shimizu K, Toriyama F, Zhang HM, Yoshida H. Source: Carcinogenesis. 1995 October; 16(10): 2327-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7586130

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The nature of solar keratosis. Author(s): Silver SE. Source: Cutis; Cutaneous Medicine for the Practitioner. 2003 December; 72(6): 447; Author Reply 447, 450. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14700215

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The sick lip--actinic keratosis of the lower lip. Author(s): Harreman FH. Source: Can Forces Dent Serv Bull. 1980 June; (1): 4-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6934022

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The use of topical fluorouracil to treat actinic keratosis. Author(s): Robins P, Gupta AK. Source: Cutis; Cutaneous Medicine for the Practitioner. 2002 August; 70(2 Suppl): 4-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12353679

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Topical treatment of actinic keratosis with fluorouracil: is irritation associated with efficacy? Author(s): Jorizzo J. Source: J Drugs Dermatol. 2004 January-February; 3(1): 21-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14964743

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Topical tretinoin in actinic keratosis and basal cell carcinoma. Author(s): Peck GL. Source: Journal of the American Academy of Dermatology. 1986 October; 15(4 Pt 2): 82935. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3534022

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Treatment of actinic keratosis. Author(s): Kestel J Jr. Source: Archives of Dermatology. 1970 September; 102(3): 351. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5456030

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Ultraviolet light downregulates CD95 ligand and TRAIL receptor expression facilitating actinic keratosis and squamous cell carcinoma formation. Author(s): Bachmann F, Buechner SA, Wernli M, Strebel S, Erb P. Source: The Journal of Investigative Dermatology. 2001 July; 117(1): 59-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11442750

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Ultraviolet-induced dna repair synthesis in lymphocytes from patients with actinic keratosis. Author(s): Lambert B, Ringborg U, Swanbeck G. Source: The Journal of Investigative Dermatology. 1976 November; 67(5): 594-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=789782

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Update on actinic keratosis and Bowen's disease in clinical trial experience. Author(s): Salasche SJ. Source: The British Journal of Dermatology. 2003 November; 149 Suppl 66: 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616344

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Utility of step sections: demonstration of additional pathological findings in biopsy samples initially diagnosed as actinic keratosis. Author(s): Carag HR, Prieto VG, Yballe LS, Shea CR. Source: Archives of Dermatology. 2000 April; 136(4): 471-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10768645

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CHAPTER 2. PATENTS ON ACTINIC KERATOSIS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.4 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “actinic keratosis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on actinic keratosis, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Actinic Keratosis By performing a patent search focusing on actinic keratosis, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 4Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on actinic keratosis: •

Compositions and methods of treatment using peat derivatives Inventor(s): Harnisch; James P. (Mercer Island, WA), Hart; Ralph M. (Lake Forest Park, WA), Jones; Herman L. (Wenatchee, WA), Jones; Veronica Lee Egelkrout (Wenatchee, WA), Kenny; Margaret A. (Edmonds, WA), Loev; Bernard (Medford, NJ), Malik; Sohail (Redmond, WA) Assignee(s): C-p Technology Limited Partnership (mill Creek, Wa) Patent Number: 6,267,962 Date filed: June 30, 1997 Abstract: Novel compositions containing at least one biologically active component derived from peat or similar composition, methods for their preparation and therapeutic uses for a variety of diseases, injuries, and conditions, including wound healing, pain, itch, inflammation, abnormal cell proliferation, or infections caused by fungal, bacterial, rickettsial or viral agents, psoriasis, allergic and other dermatitis, pruritis, eczema, actinic keratosis and similar conditions. In addition, the compositions can be used as diuretics, antiarrhythmics, and cardiac-stimulating agents, as well as for the treatment of mammalian diseases and disorders, including multiple drug resistance, cancers, asthma, rheumatoid arthritis, pain, wound healing, fungal disorders, and other inflammatory disorders. The compositions are derivable from peat or peat-related substances and may alternatively be synthetically produced. Excerpt(s): This invention relates to novel compositions, methods of isolation and synthesis, and pharmaceutical uses of materials derived from peat. These compositions may be used for the treatment of wounds and for diseases and disorders such as pruritis, psoriasis, allergic and other dermatitis, eczema, and actinic keratosis. The compositions may be suitable for accelerating wound healing; relieving pain, itch or inflammation; reducing abnormal proliferative cell growth, particularly keratinocytes, of the skin and for hyperplastic and neoplastic conditions of other epithelial systems in the human body; and providing antifungal, antiviral, or antibacterial activity. In addition, the composition can be used as a diuretic, antiarrhythmic, and cardiac-stimulating agent. It may also be used as a therapeutic agent in the treatment of multiple drug resistance, malignancies, asthma, rheumatoid arthritis, fungal infections, and inflammatory disorders. Normal skin epidermis is a complex epithelial tissue containing keratinocytes that are proliferating, differentiating, and desquamating. Many common diseases of the skin epidermis, such as psoriasis, squamous cell carcinoma, keratoacanthoma, actinic keratosis, and warts, are characterized by localized abnormal proliferation and growth that is localized. For example, in psoriasis, which is characterized by scaly, red, elevated plaques on the skin, the keratinocytes are known to proliferate much more rapidly than normal. Eczema is a superficial inflammatory process involving primarily the epidermis, marked early by redness, itching, minute papules and vesicles, weeping, oozing, and crusting, and later by scaling, lichenification, and often pigmentation. Clinical use of available treatments for diseases involving epidermal conditions is often limited by toxicity, either systemic or local. For example, methotrexate, although generally effective for treating epidermal conditions when administered orally, is rarely administered orally for fear of hepatic or bone marrow toxicity. Topical application of methotrexate has minimal or no therapeutic effect. Similarly, although topical application of 5-fluorouracil may be an effective treatment

Patents 25

for psoriasis, it is generally considered to be unacceptably irritating. Steroid therapy, though effective, is associated with adverse side effects that are potentially so numerous or serious that prolonged use is discouraged. Photochemotherapy with psoralens and ultraviolet light, or PUVA (psoralens and UV treatment), is generally effective for treatment of epidermal conditions, but it is inconvenient to administer and causes side effects and may even cause photomutagenic and photocarcinogenic reactions. Web site: http://www.delphion.com/details?pn=US06267962__ •

Cosmetic/dermatological w/o emulsions highly concentrated in hydroxy acids Inventor(s): Allec; Josiane (Antibes, FR), Ferrandis; Agnes (Mougins, FR), Preuilh; Isabelle (Antibes, FR), Willcox; Nathalie (Le Rouret, FR) Assignee(s): Centre International DE Recherches Dermatologiques Galderma (valbonne, Fr) Patent Number: 5,863,544 Date filed: December 14, 1995 Abstract: Topically applicable cosmetic/dermatological compositions well suited for the therapeutic treatment or care of human skin, nails, hair and/or of the scalp, in particular for treating and/or preventing xerosis, ichthyosis, actinic keratosis and/or photoinduced cutaneous aging, comprise a water-in-oil emulsion containing (a) at least 10% by weight of at least one hydroxy acid, (b) an effective emulsifying amount of at least one polyoxyalkylenated silicone, and (c) an effective coemulsifying amount of at least one polyol alkyl ester, polyol alkyl ether or oxyalkylenated alkyl ether, with the proviso that the subject compositions are devoid of any C.sub.1 -C.sub.4 alkanol. Excerpt(s): The present invention relates to novel cosmetic/dermatological compositions for topical application, comprising water-in-oil emulsions containing a high content of hydroxy acids, for therapeutic treatment or care of the skin, nails or hair and/or of the scalp, and to the use of same, in particular for treating and/or preventing xerosis, ichthyosis, actinic keratosis and/or photoinduced cutaneous aging. It is known to this art to employ hydroxy acids for preventing or reducing the dermatological signs of aging of the skin and/or of hair, which are due to factors that are intrinsic to aging or else to external factors, such as, especially, UV irradiation, air pollution, wind, cold, heat and cigarette smoke. These are also known active agents for treating dermatological afflictions related to a disorder of the keratinization of the skin, nails and/or hair, such as especially acne, xerosis, ichthyosis and actinic keratosis. However, these hydroxy acids are difficult to formulate as an emulsion in cream or milk form. Indeed, when they are incorporated in a concentrated amount, the hydroxy acids render the formulation unstable and therefore difficult to commercially exploit. Web site: http://www.delphion.com/details?pn=US05863544__

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Method for the treatment of hyperproliferative epithelial skin diseases by topical application of hydroxylated aromatic protein cross-linking compounds Inventor(s): Burke, Jr.; Terrence R. (Bethesda, MD), Stanwell; Caroline (Bethesda, MD), Yuspa; Stuart H. (Bethesda, MD) Assignee(s): The United States of America AS Represented by the Department of Health (washington, Dc) Patent Number: 5,610,185 Date filed: February 17, 1995 Abstract: The present invention relates to a method of treating hyperproliferative epithelial lesions by topical administration. The method prevents growth and actively cross-links these aberrant cells, thereby killing the cells. The present invention is useful in control and prevention of hyperproliferative epithelial disorders, such as HPVinfected cell lesions, actinic keratosis, melanomas, and malignant and pre-malignant carcinomas. Excerpt(s): The present invention relates to a novel method of treating hyperproliferative epithelial diseases. In particular, a specific class of compounds is used in the topical treatment of skin lesions. These compounds are in general, hydroxylated aromatic protein crosslinking agents and are useful for a wide range of skin diseases. Non-neoplastic and neoplastic hyperproliferative skin disorders are prevalent and present an everincreasing burden to health care providers. Increased exposure of skin to UV light in recent years has contributed to the marked increased incidence of premalignant lesions such as actinic keratoses. Superficial squamous and basal cell carcinoma levels now exceed 700,000 cases per year in the US (American Cancer Society, 1994). Similarly warts (plantar and genital) and other localized hyperproliferative conditions of the skin are extremely prevalent. At the present time, there are insufficient effective treatment options available to the clinician. Treatment modalities for these conditions include surgical resection or freezing the tissue to destroy rogue cells. These methods are not always the treatment of choice as they are non-selective and, hence, hyperproliferative cells can remain to cause recurrence or normal tissue can be damaged with the development of scar tissue. These techniques are often painful and therefore unacceptable to patients. Exfoliative acidic compounds such as salicylates are used topically to desquamate hyperproliferative skin lesions and kill cells directly, particularly in the treatment of plantar warts. However this treatment is not selective for hyperproliferative cells and is not always curative. The topical application of cytotoxic agents such as bleomycin and 5-fluorouracil (5FU) is used for the treatment of premalignant and malignant lesions and podophyllotoxin for genital warts. There is some concern about the toxicity of these agents, which work by direct cytotoxicity, interfering with DNA synthesis of proliferating cells by a variety of mechanisms. These agents have to be applied extremely carefully to avoid contact with normal skin since normal skin can be irreparably damaged, and systemic absorption of these compounds may also provide a significant risk to the patient. Retinoids, which are vitamin A derivatives, are a recent introduction for the treatment of neoplastic skin lesions. Unfortunately, these compounds are suppressive rather than curative and withdrawal of the drug leads to recurrence. Web site: http://www.delphion.com/details?pn=US05610185__

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Method for treating actinic keratosis with cytotoxic agents Inventor(s): Pearlman; Dale L. (21063 Christensen Dr., Cupertino, CA 95014) Assignee(s): None Reported Patent Number: 4,820,711 Date filed: May 15, 1987 Abstract: A method for treating actinic keratosis comprising applying an effective amount of a cytotoxic drug dispersed in a pharmaceutically acceptable vehicle containing a penetrating solvent for the drug, the drug being applied to the skin area having the actinic keratosis growth without occlusion in pulses at an interval of once every from 3 to 30 days and preferably at an interval of from 4 to 14 days. Optimally, the penetrating solvent is free from toxic effects, such as AZONE or similar substituted azacycloalkyl-2-ones, tertiary amine oxides, and the like. Excerpt(s): This invention relates to the therapeutic treatment of skin disorders such as actinic keratoses. In particular, this invention relates to an effective regimen for successfully treating actinic keratoses with a cytotoxic agent such as fluorouracil (5fluorouracil or 5--FU) in a penetrating solvent. Actinic keratosis is a horny growth, such as a wart or callosity on the skin, generally sharply outlined, red or skin-colored, flat or elevated, verrucous or keratotic growth, which may develop into a cutaneous horn, or may give rise to squamous cell carcinoma. It usually affects the middle-aged or elderly, especially those of fair complexion and is caused by excessive exposure to the sun. Traditional treatments of actinic keratosis have included daily or more frequent application of cytotoxic agents such as fluorouracil with or without an occlusive dressing, dissolved or suspended in an ointment, lotion, or glycol solvent applied to the affected area. Penetrating solvents have been investigated for enhancing percutaneous absorption of fluorouracil in an effort to more successfully treat more resistive conditions. Web site: http://www.delphion.com/details?pn=US04820711__

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Method for treating epithelial precancerous lesions with topical inidazoles Inventor(s): Brugnara; Carlo (Newton Highlands, MA), Halperin; Jose (Brookline, MA), Haynes; Harley (Bedford, MA) Assignee(s): President & Fellows of Harvard College (cambridge, Ma) Patent Number: 5,556,871 Date filed: April 24, 1995 Abstract: A method of treating epithelial precancerous lesions is provided. The method involves the administration of certain imidazoles to an epithelial precancerous lesion. The preferred imidazoles are clotrimazole, miconazole, econazole and ketoconazole. The method of the invention is especially useful in treating actinic keratosis. Excerpt(s): Precancerous skin lesions of keratinocytes are those areas of skin in which tissue shows the tendency to develop into cancer, although the tissue in its present state is not a cancer. Epithelial precancerous lesions include actinic keratosis (also called solar keratosis or senile keratosis), hypertrophic actinic keratosis, Bowenoid actinic keratosis, arsenical keratosis, hydrocarbon keratosis, thermal keratosis, radiation keratosis, chronic scar keratosis, viral keratosis, Bowen's disease, erythroplaquia of queyrat, oral erythroplaquia, leukoplakia, and intraepidermal epithelialoma. Actinic

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keratosis is the most common epithelial precancerous lesion among fair skinned individuals. It is usually present as lesions on the skin which may or may not be visually detectable. The size and shape of the lesions varies. It is a photosensitive disorder and may be aggravated by exposure to sunlight. If left untreated, the lesions may proceed to form atypical squamous cells, one example of which is Bowenold actinic keratosis. Bowenoid actinic keratosis is another form of an epithelial precancerous lesion. In some cases, the lesions may develop into an invasive form of squamous cell carcinoma and may pose a significant threat of metastasis. Actinic keratosis is characterized by an inflammatory infiltration of lymphocytes, histocytes and a variable number of plasma cells. It further is characterized by proliferation of keratinocytes. There also is evidence that actinic keratosis has mutations of the P53 and H-RAS oncogenes that probably are related to the malignant potential of the lesions. Web site: http://www.delphion.com/details?pn=US05556871__ •

Treatment of basal cell carcinoma and actinic keratosis employing hyaluronic acid and NSAIDs Inventor(s): Asculai; Samuel Simon (Toronto, CA), Falk; Rudolf Edgar (Toronto, CA) Assignee(s): Hyal Pharmaceutical Corporation (mississauga, Ca) Patent Number: 5,639,738 Date filed: February 21, 1992 Abstract: A method of treating a mammal for a condition of the skin or exposed tissue selected from the group consisting of basal cell carcinoma and actinic keratosis is provided. The method consists essentially of topically administering to the site of the condition, more than once per day over a period of days sufficient to treat the condition, a non-toxic effective dosage amount of a composition consisting essentially of(a) a nonsteroidal anti-inflammatory drug (NSAID) in an amount sufficient to block prostaglandin synthesis,(b) hyaluronic acid or a pharmaceutically acceptable salt thereof in an amount effective to transport said NSAID into the skin or exposed tissue at the site of the condition. The concentration of the hyaluronic add or salt thereof is between 1-3% by weight of the composition. The molecular weight of the hyaluronic acid or salt thereof is between 150,000 and 750,000 Daltons. A pharmaceutical excipient suitable for topical application is included. The NSAID in the composition may be diclofenac sodium. Excerpt(s): This invention also relates to formulations suitable for use in such treatments, the use of such formulations in such treatments, methods of such treatment, and the delivery of drugs for such treatments. Basal cell carcinoma is presently treated by surgery. Each lesion, together with all surrounding and underlying tissue (dermis, epidermis, and subdermis), is cut out. In some instances, surgery, while necessary for the patient's welfare, may put the patient at risk in some other respect (for example, a lesion on a patient's temple whose removal (resection) may jeopardize the patient's health). Squamous cell tumours are also treated the same way as are other forms of cancer in the skin and exposed tissue. Furthermore, other conditions and diseases of the skin and exposed tissue are treated the same way or in ways that cause discomfort to the patient, for example melanoma, genital warts, cervical cancer, HPV (Human Papilloma Virus). Actinic keratoses lesion is dealt with similarly. Additionally, liquid nitrogen has been used to remove the lesion. Web site: http://www.delphion.com/details?pn=US05639738__

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Patent Applications on Actinic Keratosis As of December 2000, U.S. patent applications are open to public viewing.5 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to actinic keratosis: •

Curcumin and curcuminoid inhibition of angiogenesis Inventor(s): Arbiser, Jack L.; (Atlanta, GA) Correspondence: Patrea L. Pabst; Holland & Knight Llp; Suite 2000, One Atlantic Center; 1201 West Peachtree Street, N.E.; Atlanta; GA; 30309-3400; US Patent Application Number: 20010025034 Date filed: January 18, 2001 Abstract: Methods for treating diseases or disorders of the skin which are characterized by angiogenesis have been developed using curcumin and curcumin analogs. Based on the results obtained with curcumin, it has been determined that other angiogenesis inhibitors can also be used to treat these skin disorders. It has further been discovered that curcumin acts to inhibit angiogenesis in part by inhibition of basic fibroblast growth factor (bFGF), and thereby provides a means for treating other disorders characterized by elevated levels of bFGF, such as bladder cancer, using curcumin and other analogues which also inhibit bFGF. Representative skin disorders to be treated include the malignant diseases angiosarcoma, hemangioendothelioma, basal cell carcinoma, squamous cell carcinoma, malignant melanoma and Karposi's sarcoma, and the nonmalignant diseases or conditions including psoriasis, lymphangiogenesis, hemangioma of childhood, Sturge-Weber syndrome, verruca vulgaris, neurofibromatosis, tuberous sclerosis, pyogenic granulomas, recessive dystrophic epidermolysis bullosa, venous ulcers, acne, rosacea, eczema, molluscum contagious, seborrheic keratosis, and actinic keratosis. Excerpt(s): The invention is generally in the field of methods of inhibiting angiogenesis, and more specifically is drawn to methods and compositions for inhibiting angiogenesis. Current treatments of cancer and related diseases have limited effectiveness and numerous serious unintended effects. Based primarily on chemical, radiation and surgical therapy, these treatments have progressed only incrementally during more than thirty years of intensive research to discover the origins and devise improved therapies of neoplastic diseases. Current research strategies emphasize the search for effective therapeutic modes with less risk, including the use of natural products and biological agents. This change in emphasis has been stimulated by the fact that many of the consequences, to patients and their offspring, of conventional cancer treatment, including new cancers, mutations and congenital defects, result from their actions on genetic material and mechanisms. Hong et al., J. Natl. Cancer Inst. Monogr. 17:49-53 (1995). Efforts continue to discover the origins of cancer at the genetic level, and correspondingly new treatments, but such interventions also may have serious unanticipated effects. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

5

This has been a common practice outside the United States prior to December 2000.

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Method for treating the pathological lesions of the skin that develop by ultraviolet radiation of the sunlight Inventor(s): Farkas, Bea; (Szeged, HU), Nagy, Peter Literati; (Budapest, HU), Vadasz, Agnes; (Budapest, HU), Vigh, Laszlo; (Szeged, HU) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20020131938 Date filed: December 7, 2001 Abstract: The invention relates to methods for prevention and/or treatment of skin lesions caused by exposure to ultraviolet radiation. Exemplary condition that can be prevented or treated are actinic keratosis, dry skin,polymorphic light exanthema, photopathology, photo-allergy, solar atrophy, stria migrans, elastoma diffusum, X-ray dermatits, gouty polychondritis and decubitis ulcer. The method employs application to the skin of a composition comprising a hydroximic acid derivative of the formula 1 Excerpt(s): The invention refers to a method for treating the pathological lesions of the skin that normally develop due to the ultraviolet (UV) radiation of the sunlight. Exposure of human skin to sunlight has several known unpleasant effects such as sunburn and pathological lesions leading to carcinogenesis. Due to the ultraviolet radiation of sunlight, free radicals (e.g. hydroxy radicals or nascent oxygen) form in the skin. Such free radicals can injure the DNA of skin cells and contribute to photoaging of the skin. Photoaging is characterized by clinical, histological and biochemical changes which differ from alterations in chronologically aged but sunprotected skin [Herschenfeld, R. E. et al.: The cumulative effect of ultraviolet radiation on the skin photoaging, in Photodermatology, Hawk, J. L. M. , Ed., Arnold, London, Sydney, Oakland, 1999, 89-102]. Photoaging includes changes attributable to chronic sun exposure and results in dry skin, wrinkling, laxity or even a variety of benign neoplasms. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method of treating actinic keratosis Inventor(s): Bhagwat, Dileep; (Bronxville, NY), Glassman, Bradley P.; (Fairfield, NJ), Glassman, Daniel; (Fairfield, NJ) Correspondence: Covington & Burling; Attn: Patent Docketing; 1201 Pennsylvania Avenue, N.W.; Washington; DC; 20004-2401; US Patent Application Number: 20030212127 Date filed: May 9, 2002 Abstract: Described is a novel approach for treating actinic keratosis which involves the use of urea in a dermatological composition. The urea composition can be included in pre-treatment, treatment and post-treatment steps. Also described are novel topical compositions for the treatment step containing a combination of urea and a pharmaceutical agent for treating actinic keratosis, such as a caustic agent, 5fluorouracil or a photosensitizing agent. Excerpt(s): The present invention relates to an improved method of treating actinic keratosis. This invention changes the focus of treating actinic keratosis from a singular event to a comprehensive procedure, which includes the use of a composition

Patents 31

containing urea as a principal component and can include pre-treatment, treatment and post-treatment. Treatment may involve concurrent or non-concurrent topical applications. Actinic Keratoses (AKs) are very common, precancerous lesions that arise on photodamaged skin. Extensive sun exposure and skin type are the most important factors in their development. The term actinic means that development of the lesions results from exposure to ultraviolet (UV) radiation, the primary source of which is sunlight. Keratosis is a general term for skin lesions characterized by overgrowth and thickening of the stratum corneum. There is a strong correlation between sun exposure and the occurrence of AKs. Commonly affected sites are the balding scalp, forehead, face, ears, neck, and back of the forearms and hands. Although most AKs develop on the head and upper extremities, they can also occur on the legs or anywhere where there has been excessive exposure to UV radiation. Also, the lesions can develop as a result of UV light exposure from artificial sources, such as tanning booths. Medical radiation exposure or exposure through occupational means may also cause AKs. After several years, a small percentage of AKs degenerate to squamous cell carcinomas. Thus, the lesions require careful evaluation and effective treatment. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method of treatment for dermatological disorders and compositions therefor Inventor(s): Levy, Sharon F.; (Philadelphia, PA), Tobey, Raymond E.; (Radnor, PA) Correspondence: Aventis Pharmaceuticals, INC.; Patents Department; Route 202-206, P.O. Box 6800; Bridgewater; NJ; 08807-0800; US Patent Application Number: 20020009497 Date filed: December 20, 2000 Abstract: A composition and method of treatment of dermatological disorders using 5fluorouracil at levels below about 1.0%. The disorders to be treated include actinic keratosis, non-malignant lesions of the skin and psoriasis. Excerpt(s): This application is a continuation of PCT/US99/14354, filed Jun. 24, 1999, which claims priority from U.S. Provisional Patent Application No. 60/090,892, filed Jun. 26, 1998. The present invention relates to a novel method of treatment of dermatological disorders such as actinic or solar keratoses using low levels of 5Fluorouracil and compositions therefor. Actinic keratosis is a type of epithelial precancerous lesion. Sun exposure for many years and poor pigmentation of the skin (i.e., light-colored skin) predispose one to developing actinic keratosis. Actinic keratosis has been treated in various ways, including cryosurgery, ionizing radiation in the form of X-rays, and topical chemotherapy such as that using fluorouracil or trichloroacetic acid. Actinic keratosis is sometimes referred to as solar keratosis or senile keratosis. Actinic keratosis is considered by some as a form of carcinoma in situ; actinic keratosis may progress to overt squamous cell carcinoma. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Actinic Keratosis

Pharmaceutical formulation comprising an immune response modifier Inventor(s): Busch, Terri F.; (St. Paul, MN), Fretland, Mary; (Eagan, MN), Gust-Heiting, Amy L.; (Hudson, WI), Scholz, Matthew T.; (Woodbury, MN), Skwierczynski, Raymond D.; (Oakdale, MN) Correspondence: Attention: Dean A. Ersfeld; Office OF Intellectual Property Counsel; 3M Innovative Properties Company; P.O. Box 33427; ST. Paul; MN; 55133-3427; US Patent Application Number: 20030199538 Date filed: November 27, 2002 Abstract: Pharmaceutical formulations comprising an immune response modifier (IRM) chosen from imidazoquinoline amines, imidazotetrahydroquinoline amines, imidazopyridine amines, 6,7-fused cycloalkylimidazopyridine amines, 1,2-bridged imidazoquinoline amines, thiazolo-quinolineamines, oxazolo-quinolinamines, thiazolopyridinamines, oxazolo-pyridinamines, imidazonaphthyridine amines, tetrahydroimidazonaphthyridine amines, and thiazolonaphthyridine amines; a fatty acid; and a hydrophobic, aprotic component miscible with the fatty acid are useful for the treatment of dermal associated conditions. Novel topical formulations are provided. In one embodiment, the topical formulations are advantageous for treatment of actinic keratosis, postsurgical scars, basal cell carcinoma, atopic dermatitis, and warts. Excerpt(s): This application claims priority to Provisional Patent Application Serial No. 60/340,605, filed Nov. 29, 2001 and Provisional Patent Application Serial No. 60/378,452, filed May 6, 2002. The present invention is directed to pharmaceutical formulations comprising at least one immune response modifier chosen from imidazoquinoline amines, imidazopyridine amines, 6,7-fused cycloalkylimidazopyridine amines, 1,2-bridged imidazoquinoline amines, thiazoloquinoline amines, oxazoloquinoline amines, thiazolopyridine amines, oxazolopyridine amines, imidazonaphthyridine amines, imidazotetrahydronaphthyridine amines, and thiazolonaphthyridine amines. Embodiments of the present invention are directed to topical formulations for application to the skin of a mammal. Other embodiments of the present invention are directed to methods for treating dermal diseases. Many imidazoquinoline amine, imidazopyridine amine, 6,7-fused cycloalkylimidazopyridine amine, 1,2-bridged imidazoquinoline amine, thiazoloquinoline amine, oxazoloquinoline amine, thiazolopyridine amine, oxazolopyridine amine, imidazonaphthyridine amine, imidazotetrahydronaphthyridine amine, and thiazolonaphthyridine amine compounds have demonstrated potent immunostimulating, antiviral and antitumor (including anticancer) activity, and have also been shown to be useful as vaccine adjuvants. These compounds are hereinafter collectively referred to as "IRM" (immune response modifier) compounds. One of these IRM compounds, known as imiquimod, has been commercialized in a topical formulation, Aldara.TM., for the treatment of anogenital warts associated with human papillomavirus. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with actinic keratosis, you can access the U.S. Patent Office archive via the Internet at the following Web

Patents 33

address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “actinic keratosis” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on actinic keratosis. You can also use this procedure to view pending patent applications concerning actinic keratosis. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 3. BOOKS ON ACTINIC KERATOSIS Overview This chapter provides bibliographic book references relating to actinic keratosis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on actinic keratosis include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “actinic keratosis” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on actinic keratosis: •

Diseases of the Oral Mucosa and the Lips Source: Orlando, FL: W.B. Saunders Company. 1993. 389 p. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522 (individuals) or (800) 782-4479 (schools); Fax (800) 874-6418 or (407) 352-3445; http://www.wbsaunders.com. PRICE: $99.00 plus shipping and handling. ISBN: 0721640397. Summary: This book is a clinically oriented atlas and text covering the symptoms and diseases of the oral mucosa and perioral skin. The authors focus on the essential aspects of each illness, concentrating on the clinical features that are important in the differential diagnosis. The authors include not only diseases confined to the oral mucosa but also those oral problems that may be signs of accompanying cutaneous (skin) or systemic diseases. Sixty-seven chapters are presented in three sections: the normal oral mucosa,

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Actinic Keratosis

general aspects of oral pathology, and diseases of the oral mucosa and the lips. Specific topics are inflammation of the lips, acquired diseases of the tongue, gingival hyperplasia, enlargement of the parotid gland, aphthous ulcers (stomatitis), pyostomatitis vegetans, disorders of pigmentation, urticaria and angioedema, psoriasis, Reiter's syndrome, lichen planus, graft-versus-host disease, rosacea, perioral dermatitis, erythema multiforme, acute febrile neutrophilic dermatosis (Sweet's syndrome), vesicular and bullous autoimmune diseases, desquamative gingivitis, necrotizing sialometaplasia, oral mucosal hemorrhage, viral diseases, bacterial diseases, fungal diseases, protozoal and parasitic diseases, mechanical damage, trauma, allergic and toxic contact stomatitis, occupational diseases of the oral mucosa, drug reactions and side effects, morphea and scleroderma, lichen sclerosus et atrophicus, dermatomyositis, lupus erythematosus, Sjogren's syndrome, polyarteritis nodosa, giant cell arteritis, plasma cell gingivitis, oral submucous fibrosis, halitosis, xerostomia, sialorrhea, selfinduced mucosal injuries, benign granulomatous processes, malignant granulomatoses, heterotopias and congenital malformations, genodermatoses and congenital syndromes, benign and malignant tumors, actinic keratosis, leukoplakia, paraneoplastic disorders, and oral signs of hematologic, nutritional, metabolic, and endocrine disorders. Each chapter includes full-color photographs and references are provided in individual sections. A subject index concludes the volume. (AA-M).

Chapters on Actinic Keratosis In order to find chapters that specifically relate to actinic keratosis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and actinic keratosis using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “actinic keratosis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on actinic keratosis: •

Premalignant Lesions Source: in Ord, R.A. and Blanchaert, R.H., eds. Oral Cancer: The Dentist's Role in Diagnosis, Management, Rehabilitation, and Prevention. Chicago, IL: Quintessence Publishing Co, Inc. 1999. p. 49-63. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $79.00 plus shipping and handling. ISBN: 0867153571. Summary: Dentists are involved in the diagnosis, treatment, rehabilitation, reconstruction, and prevention of oral cancer. This chapter on premalignant oral lesions is from a book written specifically for dental health care providers, including dental students, general dentists, dental specialists, and hygienists. The author discusses leukoplakia (white patches), erythroleukoplakia, erythroplakia (red patches), actinic keratosis (a premalignant skin condition), oral lichen planus, problems associated with smokeless tobacco use, proliferative verrucous leukoplakia (PVL), human papillomavirus, and lesions associated with AIDS. The bulk of the chapter consists of full color photographs of the lesions under discussion. 12 figures. 26 references.

Books

•

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Premalignant and Malignant Epithelial Tumors of Mucosa and Skin Source: in Marx, R.E.; Stern, D. Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment. Chicago, IL: Quintessence Publishing Co, Inc. 2003. p.283-373. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $ 399.00 plus shipping and handling. ISBN: 0867153903. Summary: This chapter on premalignant and malignant epithelial tumors of mucosa and skin is from a clinically oriented guide for oral and maxillofacial surgeons and other advanced dental and medical specialists who deal with pathologies in the oral cavity, midface, and neck. Introductory sections review the biology of cancer, including the causes of cancer, cancer progression, oncogenes, tumor suppressor genes, biology of metastasis, and how cancer kills; and principles of cancer treatment, including surgical treatment, radiotherapy, chemotherapy, and management of the terminal cancer patient. The authors then discuss premalignant and nonpremalignant conditions, including erythroplakia and leukoplakia, nicotinic stomatitis, smokeless tobacco keratosis, submucous fibrosis, verrucous carcinoma, and proliferative verrucous leukoplakia; mucosal squamous cell carcinomas, including diagnostic considerations, and squamous cell carcinoma of the lips, oral tongue, pharyngeal tongue, floor of the mouth, buccal (cheek) mucosa, retromolar trigone, gingival, alveolar ridge, palate, and maxillary sinus, and undifferentiated nasopharyngeal carcinoma; premalignant conditions and malignancies of skin, including actinic keratosis, keratoacanthoma, basal cell carcinoma, squamous cell carcinoma of skin, and Merkel cell tumor; and malignant tumors of adnexal structures, including malignant syringoma (microcystic adnexal carcinoma), ductal eccrine carcinoma, mucinous eccrine carcinoma, pilomatrix carcinoma, and sebaceous carcinoma. For each condition, the authors discuss clinical presentation and pathogenesis, differential diagnosis, diagnostic work-up, histopathology, treatment, and prognosis. Full-color photographs illustrate the chapter. 111 figures. 5 tables.

•

Chapter 79: Epithelial Precancerous Lesions Source: in Freedberg, I.M., et al., eds. Fitzpatrick's Dermatology in General Medicine. 5th ed., Vol. 1. New York, NY: McGraw-Hill. 1999. p. 823-839. Contact: Available from McGraw-Hill Customer Services. P.O. Box 548, Blacklick, OH 43004-0548. (800) 262-4729 or (877) 833-5524. Fax (614) 759-3749 or (614) 759-3641. E-mail: [email protected]. PRICE: $395.00 plus shipping and handling. ISBN: 0070219435. Summary: This chapter provides health professionals with information on the clinical manifestations, pathology, diagnosis, differential diagnosis, treatment, prevention, course, and prognosis of epithelial precancerous lesions. Precancerous skin lesions of keratinocytes are those that may evolve into invasive cancer. The most common epithelial precancerous lesion among people with light complections is actinic keratosis. The actinic keratosis presents on sun exposed body areas, usually in middle aged or older people, as a skin colored or reddish brown or yellowish black, ill defined macule or papule with a dry, adherent scale. Types of actinic keratoses include hypertrophic actinic keratoses, spreading pigmented actinic keratoses, proliferative actinic keratoses, lichenoid actinic keratoses, and bowenoid actinic keratoses. Studies have shown that actinic keratoses are a cutaneous sign in people who are at markedly increased risk for subsequent development of cutaneous squamous cell carcinoma (SCC) and melanoma. The cutaneous horn is another precancerous skin lesion. This

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Actinic Keratosis

morphologic lesion, a conical, dense hyperkeratotic nodule that resembles the horn of an animal, can be produced by various disorders. Arsenical keratoses are those resulting from arsenic exposure. They develop at sites of friction and trauma as multiple, punctate, hard, yellowish, often symmetric, cornlike papules. Hydrocarbon keratoses are keratotic nodules and plaques that occur on the skin as a result of exposure to certain chemicals other than arsenic. They may appear as small, usually grayish, oval, flat, premalignant papules. Thermal keratoses result from chronic stimulation from infrared radiation. Chronic radiation keratoses are premalignant electromagnetic wave induced cutaneous dysplasis. They appear as discrete keratoses or as hyperkeratotic plaques years after x ray exposure. Chronic cicatrix keratoses are those that develop at sites of chronic scar formation. These keratoses appear as papules or erosions. Bowenoid papulosis, which is caused by human papillomavirus infection, is a genital eruption of papules or plaques showing characteristic bowenoid histology. Bowen's disease causes a cutaneous lesion that appears as a sharply demarcated, scaly, often hyperkeratotic, sometimes fissured, macule, papule, or plaque devoid of hair. Erythroplasia of Queyrat, which occurs in men not circumcised in early childhood, is in situ or invasive SCC of the penile mucosa when the characteristic morphology is a sharply demarcated, velvety, bright reddish plaque. Erythoplasis is a red patch of the mucosal surface that often presents as an in situ or invasive SCC of the oral mucosa. Leukoplakia is a white patch or plaque on the mucosa that cannot be rubbed off. Intraepidermal epithelioma is a rare superficial cutaneous tumor that appears as a sharply demarcated, slowly enlarging, solitary gray to tannish brown, scaly hyperkeratotic plaque with a round to irregular shape. The main options for treating these epithelial precancerous lesions are excisional surgery, cryosurgery, electrodesiccation and curettage, and topical chemotherapy. 8 figures, 1 table, and 96 references.

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CHAPTER 4. PERIODICALS AND NEWS ON ACTINIC KERATOSIS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover actinic keratosis.

News Services and Press Releases One of the simplest ways of tracking press releases on actinic keratosis is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “actinic keratosis” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to actinic keratosis. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “actinic keratosis” (or synonyms). The following was recently listed in this archive for actinic keratosis: •

3M files to market Aldara cream for actinic keratosis Source: Reuters Industry Breifing Date: May 05, 2003

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Actinic Keratosis

•

Berlex Laboratories licenses rights to actinic keratosis treatment Source: Reuters Medical News Date: November 24, 1999

•

DUSA gets FDA approvable letter for actinic keratosis treatment Source: Reuters Medical News Date: June 30, 1999 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “actinic keratosis” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “actinic keratosis” (or synonyms). If you know the name of a company that is relevant to actinic keratosis, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

Periodicals and News

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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “actinic keratosis” (or synonyms).

Academic Periodicals covering Actinic Keratosis Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to actinic keratosis. In addition to these sources, you can search for articles covering actinic keratosis that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 5. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for actinic keratosis. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with actinic keratosis. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

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Actinic Keratosis

The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to actinic keratosis: Diclofenac •

Topical - U.S. Brands: Solaraze http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500247.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute6: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

6

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:8 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 8 See http://www.nlm.nih.gov/databases/databases.html. 7

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The NLM Gateway9

The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “actinic keratosis” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 876 7 68 0 4 955

HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.13 Simply search by “actinic keratosis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x. The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 11 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 12 The HSTAT URL is http://hstat.nlm.nih.gov/. 13 Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 9

10

Physician Resources

51

Coffee Break: Tutorials for Biologists14 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.15 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.16 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 16 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 14

15

53

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on actinic keratosis can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to actinic keratosis. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to actinic keratosis. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “actinic keratosis”:

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Melanoma http://www.nlm.nih.gov/medlineplus/melanoma.html Skin Aging http://www.nlm.nih.gov/medlineplus/skinaging.html Skin Diseases http://www.nlm.nih.gov/medlineplus/skindiseases.html Skin Pigmentation Disorders http://www.nlm.nih.gov/medlineplus/skinpigmentationdisorders.html Sun Exposure http://www.nlm.nih.gov/medlineplus/sunexposure.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on actinic keratosis. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Actinic Keratosis: What You Should Know About This Common Precancer Source: New York, NY: Skin Cancer Foundation. 2002. 8 p. Contact: Available from Skin Cancer Foundation. Box 561, New York, NY 10156. E-mail: [email protected]. Website: www.skincancer.org. Summary: This brochure provides information about actinic keratosis (AK), the most common type of precancerous skin lesions. AKs appear as scaly or crusty bumps most commonly found on the face, arms, scalp, neck, and lips. AKs indicate sustained sun damage that may develop into any form of skin cancer. Fair-skinned individuals with blond or red hair and blue, gray, or green eyes are at the greatest risk of developing AKs. Treatment to remove AKs is based on the nature of the lesion and the age and health of the patient and includes cryosurgery, curettage and desiccation, topical medications, chemical peeling, laser surgery, and photodynamic surgery. 4 photographs.

•

Actinic Keratosis Source: Kirksville, MO: American Osteopathic College of Dermatology (AOCD). 2001. 3 p.

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55

Contact: Available online from American Osteopathic College of Dermatology. 1501 East Illinois Street, P.O. Box 7525, Kirksville, MO 63501. (800) 449-2623 or (660) 665-2184. Fax (660) 627-2623. E-mail: [email protected]. Website: www.aocd.org/skin/dermatologic_diseases/ index.html. Summary: This fact sheet provides people who have an actinic keratosis with information on the symptoms and treatment of this skin condition. An actinic keratosis, a scaly or crusty bump that forms on the skin, ranges in size from a pinhead to an inch in diameter. A keratosis appears most often on sun exposed areas. Its presence indicates that sun damage has occurred. People who are at greatest risk for sunburn, and thus the possible development of actinic keratoses, are those who have fair skin; blonde or red hair; and blue, green, or gray eyes. An actinic keratosis is dangerous because it can be the first step in the development of skin cancer. The most aggressive form of keratosis, actinic cheilitis, appears on the lips and can progress to squamous cell carcinoma. Treatments for actinic keratosis include curettage, shave removal, cryosurgery, chemical peels, and 5-fluorouracil cream. 2 figures. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to actinic keratosis. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to actinic keratosis. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with actinic keratosis. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about actinic keratosis. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “actinic keratosis” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “actinic keratosis”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “actinic keratosis” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

Patient Resources

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “actinic keratosis” (or a synonym) into the search box, and click “Submit Query.”

59

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.17

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

17

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)18: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

18

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

61

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

63

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

65

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on actinic keratosis: •

Basic Guidelines for Actinic Keratosis Actinic keratosis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000827.htm

•

Signs & Symptoms for Actinic Keratosis Macule Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003229.htm Skin lesion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm

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Diagnostics and Tests for Actinic Keratosis Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm Skin biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003840.htm

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Background Topics for Actinic Keratosis Benign Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002236.htm Cryotherapy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002322.htm Macule Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003229.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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ACTINIC KERATOSIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Aberrant: Wandering or deviating from the usual or normal course. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Actinic keratosis: A precancerous condition of thick, scaly patches of skin. Also called solar or senile keratosis. [NIH] Adenoma: A benign epithelial tumor with a glandular organization. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by

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organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Aminolevulinic Acid: A compound produced from succinyl-CoA and glycine as an intermediate in heme synthesis. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Angioedema: A vascular reaction involving the deep dermis or subcutaneous or submucal tissues, representing localized edema caused by dilatation and increased permeability of the capillaries, and characterized by development of giant wheals. [EU] Angiogenesis inhibitor: A substance that may prevent the formation of blood vessels. In anticancer therapy, an angiogenesis inhibitor prevents the growth of blood vessels from surrounding tissue to a solid tumor. [NIH] Angiosarcoma: A type of cancer that begins in the lining of blood vessels. [NIH] Anogenital: Pertaining to the anus and external genitals. [EU] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotics: Substances produced by microorganisms that can inhibit or suppress the growth of other microorganisms. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH]

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Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimycotic: Suppressing the growth of fungi. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiproliferative: Counteracting a process of proliferation. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Atopic: Pertaining to an atopen or to atopy; allergic. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH]

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Basal cell carcinoma: A type of skin cancer that arises from the basal cells, small round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Base Pairing: Pairing of purine and pyrimidine bases by hydrogen bonding in doublestranded DNA or RNA. [NIH] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bleomycin: A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Boron: A trace element with the atomic symbol B, atomic number 5, and atomic weight 10.81. Boron-10, an isotope of boron, is used as a neutron absorber in boron neutron capture therapy. [NIH]

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Bowen: Intraepithelial epithelioma affecting the skin and sometimes the mucous membranes. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bullous: Pertaining to or characterized by bullae. [EU] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Carcinoma in Situ: A malignant tumor that has not yet invaded the basement membrane of the epithelial cell of origin and has not spread to other tissues. [NIH] Cardiac: Having to do with the heart. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Caustic: An escharotic or corrosive agent. Called also cauterant. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH]

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Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cheilitis: Inflammation of the lips. It is of various etiologies and degrees of pathology. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chondrocytes: Polymorphic cells that form cartilage. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Cicatrix: The formation of new tissue in the process of wound healing. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clotrimazole: An imidazole derivative with a broad spectrum of antimycotic activity. It inhibits biosynthesis of the sterol ergostol, an important component of fungal cell membranes. Its action leads to increased membrane permeability and apparent disruption of enzyme systems bound to the membrane. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH]

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Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Corneum: The superficial layer of the epidermis containing keratinized cells. [NIH] Coumarin: A fluorescent dye. [NIH] Cryosurgery: The use of freezing as a special surgical technique to destroy or excise tissue. [NIH]

Cryotherapy: Any method that uses cold temperature to treat disease. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Curcumin: A dye obtained from tumeric, the powdered root of Curcuma longa Linn. It is used in the preparation of curcuma paper and the detection of boron. Curcumin appears to possess a spectrum of pharmacological properties, due primarily to its inhibitory effects on metabolic enzymes. [NIH] Curettage: Removal of tissue with a curette, a spoon-shaped instrument with a sharp edge. [NIH]

Curette: A spoon-shaped instrument with a sharp edge. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dentists: Individuals licensed to practice dentistry. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatomycoses: Superficial infections of the skin or its appendages by any of various fungi. [NIH] Dermatosis: Any skin disease, especially one not characterized by inflammation. [EU] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Desiccation: Removal of moisture from a substance (chemical, food, tissue, etc.). [NIH] Diagnosis, Differential: Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic

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measures. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt, diclofenac sodium. [NIH] Diclofenac Sodium: The sodium form of diclofenac. It is used for its analgesic and antiinflammatory properties. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Diuretic: A drug that increases the production of urine. [NIH] DNA Repair: The reconstruction of a continuous two-stranded DNA molecule without mismatch from a molecule which contained damaged regions. The major repair mechanisms are excision repair, in which defective regions in one strand are excised and resynthesized using the complementary base pairing information in the intact strand; photoreactivation repair, in which the lethal and mutagenic effects of ultraviolet light are eliminated; and postreplication repair, in which the primary lesions are not repaired, but the gaps in one daughter duplex are filled in by incorporation of portions of the other (undamaged) daughter duplex. Excision repair and post-replication repair are sometimes referred to as "dark repair" because they do not require light. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophic: Pertaining to toxic habitats low in nutrients. [NIH]

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Econazole: A broad spectrum antimycotic with some action against gram-positive bacteria. It is used topically in dermatomycoses also orally and parenterally. [NIH] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrodesiccation: The drying of tissue by a high-frequency electric current applied with a needle-shaped electrode. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales.

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Also called squamous cell carcinoma. [NIH] Epidermolysis Bullosa: Group of genetically determined disorders characterized by the blistering of skin and mucosae. There are four major forms: acquired, simple, junctional, and dystrophic. Each of the latter three has several varieties. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelioma: A neoplasm of epithelial origin, ranging from benign (adenoma and papilloma) to malignant (carcinoma). [EU] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythema Infectiosum: Contagious infection with human B19 Parvovirus most commonly seen in school age children and characterized by fever, headache, and rashes of the face, trunk, and extremities. It is often confused with rubella. [NIH] Erythema Multiforme: A skin and mucous membrane disease characterized by an eruption of macules, papules, nodules, vesicles, and/or bullae with characteristic "bull's-eye" lesions usually occurring on the dorsal aspect of the hands and forearms. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythroplakia: A reddened patch with a velvety surface found in the mouth. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Exanthema: Diseases in which skin eruptions or rashes are a prominent manifestation. Classically, six such diseases were described with similar rashes; they were numbered in the order in which they were reported. Only the fourth (Duke's disease), fifth (erythema infectiosum), and sixth (exanthema subitum) numeric designations survive as occasional synonyms in current terminology. [NIH] Excipient: Any more or less inert substance added to a prescription in order to confer a suitable consistency or form to the drug; a vehicle. [EU] Excisional: The surgical procedure of removing a tumor by cutting it out. The biopsy is then examined under a microscope. [NIH] Exfoliation: A falling off in scales or layers. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the

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relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flexor: Muscles which flex a joint. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

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Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gingival Hyperplasia: A pathological increase in the depth of the gingival crevice surrounding a tooth at the gum margin. [NIH] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Gram-Positive Bacteria: Bacteria which retain the crystal violet stain when treated by Gram's method. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Halitosis: An offensive, foul breath odor resulting from a variety of causes such as poor oral hygiene, dental or oral infections, or the ingestion of certain foods. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Histology: The study of tissues and cells under a microscope. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH]

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Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Human papillomavirus: HPV. A virus that causes abnormal tissue growth (warts) and is often associated with some types of cancer. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxy Acids: Organic compounds containing both the hydroxyl and carboxyl radicals. [NIH]

Hydroxyurea: An antineoplastic agent that inhibits DNA synthesis through the inhibition of ribonucleoside diphosphate reductase. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Ichthyosis: Any of several generalized skin disorders characterized by dryness, roughness, and scaliness, due to hypertrophy of the stratum corneum epidermis. Most are genetic, but some are acquired, developing in association with other systemic disease or genetic syndrome. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppression: Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of suppressor T-cell populations or by

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inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] Incision: A cut made in the body during surgery. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltrating cancer: Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called invasive cancer. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Invasive cancer: Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles,

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etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Keratoacanthoma: A benign, non-neoplastic, usually self-limiting epithelial lesion closely resembling squamous cell carcinoma clinically and histopathologically. It occurs in solitary, multiple, and eruptive forms. The solitary and multiple forms occur on sunlight exposed areas and are identical histologically; they affect primarily white males. The eruptive form usually involves both sexes and appears as a generalized papular eruption. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Keratosis: Any horny growth such as a wart or callus. [NIH] Ketoconazole: Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients. [NIH] Kinetic: Pertaining to or producing motion. [EU] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Laser Surgery: The use of a laser either to vaporize surface lesions or to make bloodless cuts in tissue. It does not include the coagulation of tissue by laser. [NIH] Lentigo: Small circumscribed melanoses resembling, but differing histologically from, freckles. The concept includes senile lentigo ('liver spots') and nevoid lentigo (nevus spilus, lentigo simplex) and may also occur in association with multiple congenital defects or congenital syndromes (e.g., Peutz-Jeghers syndrome). [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leukoplakia: A white patch that may develop on mucous membranes such as the cheek, gums, or tongue and may become cancerous. [NIH]

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Lichen Planus: An inflammatory, pruritic disease of the skin and mucous membranes, which can be either generalized or localized. It is characterized by distinctive purplish, flattopped papules having a predilection for the trunk and flexor surfaces. The lesions may be discrete or coalesce to form plaques. Histologically, there is a "saw-tooth" pattern of epidermal hyperplasia and vacuolar alteration of the basal layer of the epidermis along with an intense upper dermal inflammatory infiltrate composed predominantly of T-cells. Etiology is unknown. [NIH] Lichenification: Hypertrophy of the epidermis, resulting in thickening of the skin with exaggeration of the normal skin markings, giving the skin a leathery barklike appearance, which is caused by prolonged rubbing or scratching. It may arise on seemingly normal skin, or it may develop at the site of another pruritic cutaneous disorder. [EU] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Liquor: 1. A liquid, especially an aqueous solution containing a medicinal substance. 2. A general term used in anatomical nomenclature for certain fluids of the body. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte Depletion: Immunosuppression by reduction of circulating lymphocytes or by T-cell depletion of bone marrow. The former may be accomplished in vivo by thoracic duct drainage or administration of antilymphocyte serum. The latter is performed ex vivo on bone marrow before its transplantation. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH]

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Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Maxillary Sinus: One of the paired paranasal sinuses, located in the body of the maxilla, communicating with the middle meatus of the nasal cavity. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Melanosomes: Melanin-containing organelles found in melanocytes and melanophores. [NIH]

Membrane: A very thin layer of tissue that covers a surface. [NIH] Meningeal: Refers to the meninges, the tissue covering the brain and spinal cord. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastasize: To spread from one part of the body to another. When cancer cells metastasize and form secondary tumors, the cells in the metastatic tumor are like those in the original (primary) tumor. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Methyl Methanesulfonate: An alkylating agent in cancer therapy that may also act as a mutagen by interfering with and causing damage to DNA. [NIH] Miconazole: An imidazole antifungal agent that is used topically and by intravenous infusion. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH]

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Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Migrans: Infestation of the dermis by various larvae, characterized by bizarre red irregular lines which are broad at one end and fade at the other, produced by burrowing larvae. [NIH] Miscible: Susceptible of being mixed. [EU] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Mutagen: Any agent, such as X-rays, gamma rays, mustard gas, TCDD, that can cause abnormal mutation in living cells; having the power to cause mutations. [NIH] Mutagenic: Inducing genetic mutation. [EU] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nevus: A benign growth on the skin, such as a mole. A mole is a cluster of melanocytes and surrounding supportive tissue that usually appears as a tan, brown, or flesh-colored spot on the skin. The plural of nevus is nevi (NEE-vye). [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by

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volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonmelanoma skin cancer: Skin cancer that arises in basal cells or squamous cells but not in melanocytes (pigment-producing cells of the skin). [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Office Visits: Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up. [NIH] Oncogenes: Genes which can potentially induce neoplastic transformation. They include genes for growth factors, growth factor receptors, protein kinases, signal transducers, nuclear phosphoproteins, and transcription factors. When these genes are constitutively expressed after structural and/or regulatory changes, uncontrolled cell proliferation may result. Viral oncogenes have prefix "v-" before the gene symbol; cellular oncogenes (protooncogenes) have the prefix "c-" before the gene symbol. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxides: Binary compounds of oxygen containing the anion O(2-). The anion combines with metals to form alkaline oxides and non-metals to form acidic oxides. [NIH] P53 gene: A tumor suppressor gene that normally inhibits the growth of tumors. This gene is altered in many types of cancer. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH] Papillomavirus: A genus of Papovaviridae causing proliferation of the epithelium, which

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may lead to malignancy. A wide range of animals are infected including humans, chimpanzees, cattle, rabbits, dogs, and horses. [NIH] Papule: A small circumscribed, superficial, solid elevation of the skin. [EU] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]

Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parasitic Diseases: Infections or infestations with parasitic organisms. They are often contracted through contact with an intermediate vector, but may occur as the result of direct exposure. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Perioral: Situated or occurring around the mouth. [EU] Peripheral stem cells: Immature cells found circulating in the bloodstream. New blood cells develop from peripheral stem cells. [NIH] Petrolatum: A colloidal system of semisolid hydrocarbons obtained from petroleum. It is used as an ointment base, topical protectant, and lubricant. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenolphthalein: An acid-base indicator which is colorless in acid solution, but turns pink to red as the solution becomes alkaline. It is used medicinally as a cathartic. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine

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(sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Photodynamic therapy: Treatment with drugs that become active when exposed to light. These drugs kill cancer cells. [NIH] Photosensitizer: A drug used in photodynamic therapy. When absorbed by cancer cells and exposed to light, the drug becomes active and kills the cancer cells. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Polyarteritis Nodosa: A form of necrotizing vasculitis involving small- and medium-sized arteries. The signs and symptoms result from infarction and scarring of the affected organ system. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU]

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Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promyelocytic leukemia: A type of acute myeloid leukemia, a quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. [NIH]

Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Kinases: A family of enzymes that catalyze the conversion of ATP and a protein to ADP and a phosphoprotein. EC 2.7.1.37. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino

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acids determines the shape and function of the protein. [NIH] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Protozoal: Having to do with the simplest organisms in the animal kingdom. Protozoa are single-cell organisms, such as ameba, and are different from bacteria, which are not members of the animal kingdom. Some protozoa can be seen without a microscope. [NIH] Pruritic: Pertaining to or characterized by pruritus. [EU] Psoralens: Substances found in many different plants, especially Psoralea corylifolia (Legume). They are used for skin diseases, especially vitiligo and as sunscreens. They interact with nucleic acids and are also used as research tools. Psoralens have a coumarin molecule with a furan ring. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH]

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Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinaldehyde: A carotenoid constituent of visual pigments. It is the oxidized form of retinol which functions as the active component of the visual cycle. It is bound to the protein opsin forming the complex rhodopsin. When stimulated by visible light, the retinal component of the rhodopsin complex undergoes isomerization at the 11-position of the double bond to the cis-form; this is reversed in "dark" reactions to return to the native transconfiguration. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although

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infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Ribonucleoside Diphosphate Reductase: An enzyme of the oxidoreductase class that catalyzes the formation of 2'-deoxyribonucleotides from the corresponding ribonucleotides using NADPH as the ultimate electron donor. The deoxyribonucleoside diphosphates are used in DNA synthesis. (From Dorland, 27th ed) EC 1.17.4.1. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Salicylic: A tuberculosis drug. [NIH] Salicylic Acids: Derivatives and salts of salicylic acid. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Scatter: The extent to which relative success and failure are divergently manifested in qualitatively different tests. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Sella: A deep depression in the shape of a Turkish saddle in the upper surface of the body of

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the sphenoid bone in the deepest part of which is lodged the hypophysis cerebri. [NIH] Sella Turcica: A bony prominence situated on the upper surface of the body of the sphenoid bone. It houses the pituitary gland. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Sialorrhea: Increased salivary flow. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes,

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filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stria: 1. A streak, or line. 2. A narrow bandlike structure; a general term for such longitudinal collections of nerve fibres in the brain. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Submucous: Occurring beneath the mucosa or a mucous membrane. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Syringoma: Adenoma of the sweat glands. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of

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the heart. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Topical: On the surface of the body. [NIH] Topical chemotherapy: Treatment with anticancer drugs in a lotion or cream applied to the skin. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tretinoin: An important regulator of gene expression, particularly during growth and development and in neoplasms. Retinoic acid derived from maternal vitamin A is essential for normal gene expression during embryonic development and either a deficiency or an excess can be teratogenic. It is also a topical dermatologic agent which is used in the treatment of psoriasis, acne vulgaris, and several other skin diseases. It has also been

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approved for use in promyelocytic leukemia. [NIH] Trichloroacetic Acid: A strong acid used as a protein precipitant in clinical chemistry and also as a caustic for removing warts. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumor suppressor gene: Genes in the body that can suppress or block the development of cancer. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ultraviolet radiation: Invisible rays that are part of the energy that comes from the sun. UV radiation can damage the skin and cause melanoma and other types of skin cancer. UV radiation that reaches the earth's surface is made up of two types of rays, called UVA and UVB rays. UVB rays are more likely than UVA rays to cause sunburn, but UVA rays pass deeper into the skin. Scientists have long thought that UVB radiation can cause melanoma and other types of skin cancer. They now think that UVA radiation also may add to skin damage that can lead to skin cancer and cause premature aging. For this reason, skin specialists recommend that people use sunscreens that reflect, absorb, or scatter both kinds of UV radiation. [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vaccine adjuvant: A substance added to a vaccine to improve the immune response so that less vaccine is needed. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU]

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Verruca: A circumscribed, cutaneous excrescence having a papilliferous surface; a small, circumscribed, epidermal tumor. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitiligo: A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Wart: A raised growth on the surface of the skin or other organ. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

97

INDEX A Aberrant, 26, 67 Acetylcholine, 67, 84 Acne, 25, 29, 67, 94 Acne Vulgaris, 67, 94 Adenoma, 67, 76, 93 Adjuvant, 67 Adrenal Glands, 67, 68 Adverse Effect, 67, 92 Agar, 67, 87 Algorithms, 67, 70 Alkaline, 67, 68, 71, 85, 86 Allylamine, 67, 68 Alpha Particles, 67, 89 Alternative medicine, 40, 67 Amine, 27, 32, 67 Amino Acids, 68, 86, 88, 95 Aminolevulinic Acid, 17, 68 Ammonia, 67, 68, 93, 95 Amyloidosis, 20, 68 Analgesic, 68, 74 Analog, 68, 77 Anaplasia, 68 Angioedema, 36, 68 Angiogenesis inhibitor, 29, 68 Angiosarcoma, 29, 68 Anogenital, 32, 68 Antiarrhythmic, 24, 68 Antibacterial, 24, 68, 92 Antibiotics, 68, 70 Antibodies, 68, 79, 87, 89 Antibody, 68, 69, 79, 80, 81, 84, 89, 90, 96 Anticoagulant, 68, 88 Antifungal, 24, 69, 81, 83 Antigen, 12, 68, 69, 79, 80 Anti-inflammatory, 28, 69, 74, 91 Antimetabolite, 69, 77, 83 Antimycotic, 69, 72, 75 Antineoplastic, 69, 70, 77, 79, 83, 87 Antioxidant, 18, 69 Antiproliferative, 15, 69 Antipyretic, 69, 74 Antiviral, 24, 32, 69 Anus, 68, 69 Aqueous, 69, 70, 73, 75, 82 Arachidonic Acid, 69, 88 Arginine, 69, 84 Arterial, 67, 69, 79, 88, 93

Arteries, 69, 70, 87 Arteritis, 36, 69 Artery, 69, 70, 83, 86 Atopic, 32, 69 Atrophy, 30, 69 Atypical, 28, 69 Autoimmune disease, 36, 69 B Bacteria, 68, 69, 78, 83, 84, 89, 92, 94, 95 Basal cell carcinoma, 4, 9, 10, 11, 15, 16, 18, 19, 22, 26, 28, 29, 32, 37, 70 Basal cells, 10, 70, 85 Base, 70, 74, 81, 86 Base Pairing, 70, 74 Basement Membrane, 20, 70, 71, 76, 81 Benign, 9, 30, 36, 66, 67, 70, 76, 81, 84, 85, 90 Biochemical, 15, 30, 69, 70 Biopsy, 4, 22, 65, 70, 76, 86 Biosynthesis, 69, 70, 72 Biotechnology, 5, 40, 49, 70 Bladder, 29, 70, 95 Bleomycin, 26, 70 Blood pressure, 70, 79, 84, 92 Blood vessel, 68, 70, 75, 81, 92, 94, 95 Bone Marrow, 24, 70, 78, 82, 88, 92 Boron, 70, 73 Bowen, 4, 9, 10, 13, 16, 17, 18, 19, 21, 22, 27, 38, 71 Brachytherapy, 71, 80, 81, 89, 96 Bradykinin, 71, 84 Buccal, 37, 71, 82, 93 Bullous, 36, 71 C Calcium, 71, 83 Callus, 71, 81 Carcinogenesis, 21, 30, 71 Carcinoma, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 24, 27, 28, 29, 31, 37, 55, 71, 76, 81, 93 Carcinoma in Situ, 21, 31, 71 Cardiac, 24, 67, 68, 71, 75 Case report, 7, 71 Caustic, 30, 71, 95 Cell Division, 69, 71, 78, 87 Cell membrane, 71, 72, 87 Cell proliferation, 24, 71, 85 Cerebrum, 71, 95

98

Actinic keratosis

Cervical, 28, 71 Cervix, 71, 72 Cheilitis, 21, 55, 72 Chemotherapy, 14, 37, 72 Chondrocytes, 72, 77 Chromatin, 72, 82 Chronic, 4, 27, 30, 38, 67, 72, 80, 89, 91, 93, 96 Cicatrix, 38, 72 CIS, 72, 90 Clinical trial, 5, 22, 49, 72, 74, 90 Cloning, 70, 72 Clotrimazole, 27, 72 Coagulation, 71, 72, 81, 94 Collagen, 70, 72, 77, 83, 87 Computational Biology, 49, 72 Congestion, 72, 76 Conjunctiva, 6, 72 Connective Tissue, 70, 72, 73, 77, 82, 91 Contraindications, ii, 73 Corneum, 31, 73, 75, 79 Coumarin, 73, 89 Cryosurgery, 31, 38, 54, 55, 73 Cryotherapy, 4, 5, 17, 66, 73 Curative, 26, 73, 94 Curcumin, 29, 73 Curettage, 4, 38, 54, 55, 73 Curette, 73 Cutaneous, 4, 6, 9, 10, 11, 13, 14, 15, 16, 19, 20, 21, 25, 27, 35, 37, 73, 82, 96 Cyclic, 73, 78, 84, 88 Cytoplasm, 71, 73, 82 Cytotoxic, 26, 27, 73, 79, 89, 90 Cytotoxicity, 26, 67, 73 D Deamination, 73, 95 Deletion, 18, 73 Dendritic, 73, 83 Dentists, 36, 73 Dermatitis, 24, 32, 36, 73, 75 Dermatomycoses, 73, 75 Dermatosis, 36, 73 Dermis, 28, 68, 73, 84, 93 Desensitization, 73, 79 Desiccation, 54, 73 Diagnosis, Differential, 37, 73 Diagnostic procedure, 23, 40, 74 Diastolic, 74, 79 Diclofenac, 28, 44, 74 Diclofenac Sodium, 28, 74 Diffusion, 74, 80 Digestive tract, 74, 92, 93

Direct, iii, 26, 43, 74, 86, 90 Discrete, 38, 74, 82 Diuretic, 24, 74 DNA Repair, 22, 74 Dorsal, 74, 76, 87 Dorsum, 4, 74 Double-blind, 12, 74 Drug Interactions, 44, 74 Drug Resistance, 24, 74 Drug Tolerance, 74, 94 Dysplasia, 6, 74 Dystrophic, 29, 74, 76 E Econazole, 27, 75 Eczema, 24, 29, 75 Edema, 68, 75 Efficacy, 12, 19, 22, 75 Elective, 20, 75 Electrode, 75 Electrodesiccation, 4, 38, 75 Electrons, 69, 70, 75, 80, 85, 89, 90 Emulsion, 25, 75 Endogenous, 75, 94 Endothelial cell, 75, 77, 94 Endothelium, 75, 84 Endothelium-derived, 75, 84 Environmental Health, 48, 50, 75 Enzyme, 72, 75, 78, 90, 91, 94, 96 Epidermal, 24, 75, 81, 82, 83, 96 Epidermis, 24, 28, 70, 73, 75, 79, 81, 82 Epidermoid carcinoma, 75, 93 Epidermolysis Bullosa, 29, 76 Epithelial, 24, 26, 27, 31, 37, 67, 71, 76, 81, 85 Epithelioma, 38, 71, 76 Epithelium, 70, 75, 76, 85 Erythema, 36, 76, 95 Erythema Infectiosum, 76 Erythema Multiforme, 36, 76 Erythrocytes, 70, 76 Erythroplakia, 36, 37, 76 Ether, 25, 76 Exanthema, 30, 76 Excipient, 28, 76 Excisional, 38, 76 Exfoliation, 19, 76 Exogenous, 75, 76 Extensor, 76, 89, 96 External-beam radiation, 76, 81, 89, 96 Extracellular, 72, 73, 76, 77, 83, 92 Extracellular Matrix, 72, 73, 76, 77, 83 Extracellular Matrix Proteins, 76, 83

99

F Facial, 77, 83, 86 Facial Nerve, 77, 86 Family Planning, 49, 77 Fat, 11, 69, 70, 77, 91, 92 Fatty acids, 77, 88 Febrile, 36, 77 Fibroblast Growth Factor, 29, 77 Fibroblasts, 11, 77 Fibrosis, 36, 37, 67, 77 Flexor, 76, 77, 82 Fluorouracil, 5, 8, 10, 11, 12, 14, 17, 19, 20, 21, 22, 24, 26, 27, 30, 31, 55, 77 Free Radicals, 30, 69, 77 Friction, 38, 77 G Gamma Rays, 77, 84, 89, 90 Gas, 68, 74, 77, 79, 84 Gastrin, 77, 78 Gene, 10, 70, 77, 78, 85, 94 Gene Expression, 78, 94 Genital, 26, 28, 38, 78 Genotype, 78, 86 Gingival Hyperplasia, 36, 78 Gingivitis, 36, 78 Gland, 36, 78, 82, 86, 87, 91, 93 Glycine, 68, 78 Governing Board, 78, 88 Graft, 36, 78 Graft-versus-host disease, 36, 78 Gram-positive, 75, 78 Gram-Positive Bacteria, 75, 78 Growth factors, 78, 85 Guanylate Cyclase, 78, 84 H Hair follicles, 73, 78, 96 Halitosis, 36, 78 Hemorrhage, 36, 78 Hepatic, 24, 78 Hereditary, 78, 90 Heredity, 67, 77, 78 Histology, 38, 78 Hormonal, 69, 78 Hormone, 13, 77, 78, 91 Horny layer, 75, 79 Human papillomavirus, 9, 13, 16, 32, 36, 38, 79 Hydrogen, 67, 70, 76, 79, 84, 85, 89 Hydrophobic, 32, 79 Hydroxy Acids, 25, 79 Hydroxyurea, 16, 79 Hyperplasia, 79, 82

Hypersensitivity, 73, 79, 91 Hypertension, 19, 79 Hypertrophy, 79, 82 I Ichthyosis, 25, 79 Imidazole, 72, 79, 83 Immune response, 7, 32, 67, 69, 79, 95, 96 Immune system, 79, 95, 96 Immunohistochemistry, 10, 14, 79 Immunologic, 79, 90 Immunosuppressant, 77, 79, 83 Immunosuppression, 4, 79, 80, 82 Immunosuppressive, 79 Immunosuppressive Agents, 79 Implant radiation, 80, 81, 89, 96 In situ, 38, 80 Incision, 80 Infarction, 80, 87 Infection, 13, 38, 76, 80, 82, 91, 93, 95, 96 Infiltrating cancer, 80 Infiltration, 15, 28, 80 Inflammation, 14, 24, 36, 67, 69, 72, 73, 77, 78, 80, 86, 87, 89, 93, 95, 96 Infusion, 80, 83 Ingestion, 78, 80 Internal radiation, 80, 81, 89, 96 Interstitial, 71, 80, 81, 96 Intoxication, 80, 96 Intracellular, 80, 84, 88 Intravenous, 80, 83 Intrinsic, 25, 70, 80 Invasive, 9, 15, 28, 37, 80 Invasive cancer, 37, 80 Ionization, 80, 81 Ionizing, 4, 31, 67, 80, 90 Irradiation, 11, 25, 81, 96 Ischemia, 69, 81 K Kb, 48, 81 Keratin, 81, 91 Keratinocytes, 24, 27, 37, 81 Keratoacanthoma, 4, 14, 19, 24, 37, 81 Keratolytic, 81, 87 Keratosis, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 24, 25, 26, 27, 28, 29, 30, 31, 32, 36, 37, 39, 40, 54, 55, 65, 67, 81 Ketoconazole, 27, 81 Kinetic, 81 L Laminin, 70, 77, 81 Laser Surgery, 54, 81

100

Actinic keratosis

Lentigo, 4, 19, 20, 81 Lesion, 7, 17, 27, 28, 31, 37, 54, 65, 81, 82, 95 Lethal, 74, 81 Leukoplakia, 27, 36, 37, 38, 81 Lichen Planus, 14, 36, 82 Lichenification, 24, 82 Lip, 12, 21, 82 Liquor, 82, 89 Liver, 68, 69, 75, 78, 81, 82, 95 Localization, 79, 82 Localized, 20, 24, 26, 68, 80, 81, 82, 87, 91, 95 Lupus, 36, 82 Lymph, 71, 75, 82 Lymph node, 71, 82 Lymphatic, 75, 80, 82, 92 Lymphocyte Depletion, 79, 82 Lymphocytes, 11, 15, 22, 28, 69, 82, 92, 96 Lymphoid, 68, 82 M Malignancy, 4, 82, 86 Malignant, 4, 8, 11, 26, 28, 29, 31, 36, 37, 69, 71, 76, 82, 84, 90, 91 Malignant tumor, 36, 37, 71, 82 Malnutrition, 69, 83 Matrix metalloproteinase, 12, 83 Maxillary, 37, 83, 86 Maxillary Sinus, 37, 83 Meatus, 83 Medical Records, 83, 90 MEDLINE, 49, 83 Melanocytes, 4, 83, 84, 85 Melanoma, 4, 11, 13, 26, 28, 29, 37, 54, 83, 95 Melanosomes, 83 Membrane, 71, 72, 76, 81, 83, 84, 85, 86, 87, 93 Meningeal, 15, 83 Meninges, 83 Metastasis, 28, 37, 83 Metastasize, 4, 83, 91 Metastatic, 16, 83, 91 Methotrexate, 24, 83 Methyl Methanesulfonate, 11, 83 Miconazole, 27, 83 Microbe, 83, 94 Microbiology, 69, 84 Microscopy, 10, 70, 84 Migrans, 30, 84 Miscible, 32, 84 Molecular, 28, 49, 51, 70, 72, 84, 94

Molecule, 69, 70, 74, 75, 84, 85, 89, 90, 95 Monitor, 84, 85 Monoclonal, 81, 84, 89, 96 Morphological, 83, 84 Morphology, 38, 84 Mucinous, 37, 84 Mucosa, 35, 37, 38, 82, 84, 93 Mucus, 84 Mutagen, 83, 84 Mutagenic, 74, 84 N Neoplasm, 76, 84, 85, 91 Neutrons, 67, 81, 84, 89 Nevus, 4, 81, 84 Nitric Oxide, 16, 84 Nitrogen, 28, 67, 76, 84 Nonmelanoma skin cancer, 4, 9, 85 Nuclear, 12, 75, 77, 85 Nucleic acid, 85, 89 Nucleus, 72, 73, 77, 82, 84, 85, 89, 93 O Office Visits, 6, 85 Oncogenes, 28, 37, 85 Opsin, 85, 90, 91 Oral Hygiene, 78, 85 Orbit, 85 Orbital, 15, 85 Organelles, 73, 83, 85 Oxidation, 69, 85 Oxides, 27, 85 P P53 gene, 9, 85 Palate, 37, 85, 93 Palliative, 85, 94 Papilloma, 28, 76, 85 Papillomavirus, 85 Papule, 37, 86 Paranasal Sinuses, 83, 86 Parasite, 86 Parasitic, 36, 86 Parasitic Diseases, 36, 86 Parotid, 36, 86 Patch, 38, 76, 81, 86 Pathologic, 70, 79, 86, 89 Pathologies, 37, 86 Patient Education, 54, 60, 62, 66, 86 Peptide, 77, 81, 86, 88 Percutaneous, 27, 86 Periodontitis, 78, 86 Perioral, 35, 86 Peripheral stem cells, 78, 86 Petrolatum, 75, 86

101

Pharmacokinetic, 5, 86 Pharmacologic, 86, 94 Phenolphthalein, 75, 86 Phenotype, 9, 14, 86 Phospholipids, 77, 86 Photodynamic therapy, 5, 17, 18, 87 Photosensitizer, 15, 87 Physiologic, 70, 87, 88, 90 Pigment, 83, 85, 87 Pigmentation, 24, 31, 36, 54, 87 Pituitary Gland, 77, 87, 92 Plants, 84, 87, 89, 94 Plaque, 38, 87 Plasma, 18, 28, 36, 68, 71, 87 Plasma cells, 28, 68, 87 Platelet Aggregation, 84, 87 Platelets, 84, 87 Pneumonia, 73, 87 Podophyllotoxin, 26, 87 Polyarteritis Nodosa, 36, 87 Polymorphic, 30, 72, 87 Polysaccharide, 69, 87, 89 Posterior, 74, 85, 87, 91 Practice Guidelines, 50, 88 Precancerous, 8, 9, 27, 31, 37, 54, 67, 88 Premalignant, 4, 6, 7, 8, 26, 36, 37, 38, 88 Progression, 8, 18, 20, 37, 88 Progressive, 74, 88 Promyelocytic leukemia, 88, 95 Prostaglandin, 28, 88 Prostaglandins A, 88 Protein C, 26, 81, 88, 95 Protein Kinases, 85, 88 Protein S, 70, 88 Proteins, 13, 68, 69, 71, 72, 76, 81, 83, 84, 85, 86, 87, 88, 94 Proteoglycans, 70, 77, 89 Protons, 67, 79, 80, 89 Protozoa, 89 Protozoal, 36, 89 Pruritic, 19, 75, 82, 89 Psoralens, 25, 89 Psoriasis, 24, 29, 31, 36, 89, 94 Psychoactive, 89, 96 Public Policy, 49, 89 Pyogenic, 29, 89 R Radiation, 4, 19, 27, 29, 30, 31, 38, 76, 77, 79, 80, 81, 89, 90, 95, 96 Radiation therapy, 4, 19, 76, 80, 81, 89, 96 Radioactive, 79, 80, 81, 85, 89, 96 Radioimmunotherapy, 89, 90

Radiolabeled, 81, 89, 96 Radiological, 86, 90 Radiotherapy, 37, 71, 81, 89, 90, 96 Randomized, 5, 17, 19, 75, 90 Receptor, 13, 22, 69, 90 Recurrence, 26, 90 Reductase, 83, 90 Refer, 1, 71, 82, 84, 89, 90, 94 Regeneration, 77, 90 Regimen, 27, 75, 90 Remission, 90 Resection, 26, 28, 90 Retinal, 90, 91 Retinaldehyde, 5, 90 Retinoblastoma, 10, 90 Retinol, 90, 91 Retrospective, 5, 90 Retrospective study, 5, 90 Rheumatoid, 24, 90 Rheumatoid arthritis, 24, 90 Rhodopsin, 85, 90, 91 Ribonucleoside Diphosphate Reductase, 79, 91 Risk factor, 4, 91 S Salicylate, 91 Salicylic, 91 Salicylic Acids, 91 Salivary, 77, 91, 92, 96 Sarcoma, 29, 91 Scatter, 91, 95 Schizoid, 91, 96 Schizophrenia, 91, 96 Schizotypal Personality Disorder, 91, 96 Sclera, 72, 91 Scleroderma, 36, 91 Screening, 72, 91 Sebaceous, 19, 37, 73, 91, 96 Sebaceous gland, 73, 91, 96 Sebum, 67, 91 Secondary tumor, 83, 91 Sella, 74, 87, 91, 92 Sella Turcica, 74, 87, 92 Senile, 27, 31, 67, 81, 92 Shock, 92, 94 Sialorrhea, 36, 92 Side effect, 25, 36, 43, 67, 92, 94 Signs and Symptoms, 87, 90, 92 Skeleton, 88, 92 Small intestine, 78, 92 Sodium, 74, 92, 93 Soft tissue, 70, 92

102

Actinic keratosis

Solid tumor, 68, 70, 92 Solvent, 27, 92 Specialist, 56, 92 Species, 84, 86, 92, 95, 96 Spectrum, 72, 73, 75, 81, 92 Spinal cord, 83, 92 Spinous, 75, 81, 92 Spleen, 68, 82, 92 Sporadic, 90, 93 Squamous, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 22, 24, 26, 27, 28, 29, 31, 37, 55, 76, 81, 85, 93 Squamous cells, 28, 85, 93 Stomach, 74, 77, 78, 92, 93 Stomatitis, 36, 37, 93 Strand, 74, 93 Stress, 91, 93, 95 Stria, 30, 93 Subacute, 80, 93 Subclinical, 80, 93 Subcutaneous, 68, 75, 93 Submucous, 36, 37, 93 Suppression, 93 Suppressive, 26, 93 Sweat, 73, 93 Sweat Glands, 73, 93 Syringoma, 37, 93 Systemic, 14, 20, 24, 26, 35, 68, 70, 79, 80, 81, 89, 91, 93, 96 Systemic disease, 35, 79, 93 Systolic, 79, 93 T Telangiectasia, 6, 94 Teratogenic, 94 Therapeutics, 5, 12, 44, 94 Thermal, 27, 38, 84, 94 Threshold, 79, 94 Thrombin, 87, 88, 94 Thrombomodulin, 88, 94 Tolerance, 4, 94 Topical, 4, 5, 11, 15, 17, 18, 21, 22, 24, 25, 26, 27, 28, 30, 31, 32, 38, 44, 54, 86, 94 Topical chemotherapy, 4, 31, 38, 94 Toxic, iv, 27, 28, 36, 73, 74, 87, 94 Toxicity, 24, 26, 74, 94 Toxicology, 50, 94 Toxin, 94

Transcription Factors, 85, 94 Transfection, 70, 94 Trauma, 36, 38, 94 Tretinoin, 22, 94 Trichloroacetic Acid, 31, 95 Tuberculosis, 82, 91, 95 Tuberous Sclerosis, 29, 95 Tumor suppressor gene, 37, 85, 95 Tunica, 84, 95 U Ulcer, 30, 95 Ultraviolet radiation, 30, 95 Urea, 30, 31, 93, 95 Urinary, 95 Urine, 70, 74, 95 Urticaria, 36, 95 Uterus, 71, 72, 95 V Vaccine, 32, 67, 95 Vaccine adjuvant, 32, 95 Vascular, 67, 68, 73, 75, 80, 84, 95 Vasculitis, 87, 95 Vasodilators, 84, 95 Vector, 86, 95 Vein, 80, 85, 86, 95 Venous, 29, 88, 95 Verruca, 29, 96 Vesicular, 36, 96 Veterinary Medicine, 49, 96 Viral, 24, 27, 36, 85, 96 Virulence, 94, 96 Virus, 28, 79, 87, 96 Vitiligo, 89, 96 Vulgaris, 29, 96 W Wart, 27, 81, 96 White blood cell, 68, 82, 84, 87, 96 Withdrawal, 26, 96 Wound Healing, 10, 24, 72, 77, 83, 96 X Xerostomia, 36, 96 X-ray, 30, 31, 77, 81, 84, 85, 89, 90, 96 X-ray therapy, 81, 96 Y Yeasts, 86, 96 Z Zymogen, 88, 96

103

104

Actinic keratosis

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