November 15, 2003

Common hyperpigmentation disorders include freckles and lentigines, caféau lait macules, and phototoxic reactions to plants or medications. Diffuse hyperpigmentation may be caused by medication side effects or by systemic conditions such as Addison's disease, hemochromatosis…

Localized hyperpigmentation disorders such as melasma, diabetic dermopathy, and postinflammatory hyperpigmentation are relatively benign but often concern patients. Acanthosis nigricans is associated with insulin resistance, and sudden onset of acanthosis nigricans or multiple…

When physicians are caring for patients who are recovering from chemical dependency, the treatment goal should be to avoid relapse. First-line therapy should be nonpharmacologic, but when medication is necessary, physicians should avoid prescribing drugs that have the potential…

Breast cyst aspiration is a simple, cost-effective, minimally invasive procedure. It is an appropriate first step in the care of women who present with a dominant breast mass suspected of being a cyst.

The 2001 Bethesda System for reporting cervical or vaginal cytologic diagnoses provides revisions in statements of adequacy, general categorization, and interpretation/results.

Primary immunodeficiencies include a variety of disorders that render patients more susceptible to infections. Early recognition and diagnosis can alter the course of these disorders significantly.

On page 1992 of this issue, you will find an article that exemplifies the 2003 Annual Clinical Focus on Prevention, an educational initiative of the American Academy of Family Physicians. The initiative is conducted in cooperation with the following organizations: the Agency…

AAFP Congress of Delegates Changes Name of Specialty to Family Medicine | HHS Report Shows Increases in Life Expectancy, Incidence of Diabetes | CDC, AAFP to Work Together on Immunization Project | AHRQ Releases Pocket Guides for Health Care Consumers | ‘Physicians with Heart…

No smoking? No problem! Creating a smoke-free area in bars and restaurants does not result in loss of income, and customers consider it a health-protective measure, according to a survey conducted in five European countries and reported in BMJ. Coordinated by Belgium's National…

In this issue of American Family Physician, Cooper and associates1 provide a timely review of the diagnostic considerations of common primary immunodeficiencies. This is an exciting time in the field of immunology. It is worth reflecting on a few recent advances and…

In its recent report on educating health professionals to keep the public healthy, the Institute of Medicine (IOM) produced a thorough and scholarly assessment of public health problems and proposed educational solutions.1 The following are paraphrased examples of some of the…

Fifty years ago, Watson and Crick1 reported the double-helical structure of DNA that would eventually earn them the Nobel Prize. Given the far-reaching implications of their report, it was notable in its brevity—occupying a single page in Nature,1 and weighing in at only 903…

A cough, vomiting, and belly pain bring 80-year-old Mrs. Conte to the emergency room this morning. Mrs. Conte has advanced nonalcoholic cirrhosis and recurrent bouts of hepatic encephalopathy. As I examine her, I'm dazzled by her smile, which is warm, gentle, and sad. Today's…

Desloratadine is somewhat effective for the treatment of seasonal allergic rhinitis and may decrease nasal congestion. It also is effective for chronic urticaria. Desloratadine is similar in effectiveness to fexofenadine and would be expected to produce results similar to…

This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for high blood pressure and the supporting scientific evidence.1 It updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, second edition.2…

Photo Quiz presents readers with a clinical challenge based on a photograph or other image.

The American College of Obstetricians and Gynecologists (ACOG) recently published a clinical management guideline on cervical cytology screening. In the United States, cervical cancer remains the third most common gynecologic malignancy.

AAP Guidelines on Taking Medication in School | AHRQ Report on Sudden Cardiac Death | Adverse Events After Smallpox Vaccination | CDC Web Site on Diethylstilbestrol

A breast cyst is a fluid-filled sac, like a tiny balloon, inside the breast. Breast cysts are common in women. They can cause a little pain, but they are usually benign (not cancer).

A primary immunodeficiency is a genetic problem with the immune system. The immune system protects the body against infection—and fights infection when it happens.

An ulcer is an opening in the lining of the stomach or in the duodenum (the first part of the small intestine). Ulcers cause a gnawing or burning pain in the stomach. However, most people who have stomach pain do not have an ulcer. Your doctor can do tests to decide if your…

Despite its name, heartburn does not affect the heart. Heartburn is a burning feeling in the lower chest, along with a sour or bitter taste in the throat and mouth. Heartburn also is called acid reflux disease, or gastroesophageal reflux disease (GERD). You might get heartburn…

Dyspepsia (say this: dis-pep-see-ah) is a burning pain or uncomfortable feeling in the upper middle part of your stomach. The pain might come and go, but usually it is there most of the time. Some people also feel bloated (a full feeling in their stomach), have heartburn, have…