Abstract: Toxic epidermal necrolysis is a rare but potentially fatal illness. The authors report a fatal case and discuss accepted and controversial management strategies.

Abstract: Skin, the largest organ in the body, undergoes numerous age-related structural and functional changes, including a delayed wound healing response. Delayed or nonhealing wounds pose an immense problem, leading to increased morbidity and mortality and an estimated cost to the United States health system in excess of $20 billion. In recent years, the important role of hormones in age-related delayed healing has become apparent, and the skin has emerged as a clear target of hormonal action. Reduced estrogen levels post-menopause have major effects on cutaneous healing, altering cytokine profiles to induce a pro-inflammatory state, modulating the balance between matrix synthesis and degradation, and attenuating keratinocyte migration. Exogenous estrogen treatment, via a systemic or topical route, can reverse many of these age-associated changes in both mouse and human models. In contrast, the effects of androgens on healing appear to be detrimental. This review will outline curren

Abstract: When a patient presents with a necrotic skin lesion, brown recluse spider bite is often considered as part of the differential diagnosis. Because patients are at risk for severe systemic symptoms that on rare occasion progress to death, failure to correctly diagnose a brown recluse spider bite can be catastrophic. However, bites are uncommon even in areas of the Midwest where brown recluse spiders are endemic. The medical literature regarding brown recluse spider bites is difficult to interpret because there is no gold standard diagnostic test. When a diagnosis is confirmed, often because a patient obtains a spider for identification, multiple therapeutic options are available including ìRICEî therapy, dapsone, and surgical excision. New diagnostic and therapeutic strategies are needed.