Editorial

Abstract

Remarkable advances have occurred in wound healing during the past decade in both basic wound biology, as well as applied research into novel treatments of chronic wounds. Newly developed therapies have included the use of growth factors to enhance wound epithelialization, and the use of bioengineered dressings, including skin substitutes. These advances were recently highlighted in the December 1998 JCMS supplement on Wound Care. The lead article in this current issue of JCMS focuses on potential mechanisms to establish quantifiable end points during wound healing, and speculates on the potential relevance to the development of novel therapies. Palenske and Morhenn have found that measurement of skin capacitance is a useful tool in determining endpoints in wound healing. While our ultimate goal in wound healing is to completely re-epithelialize and heal a wound, sometimes interventions are less successful. In evaluating wound healing agents in preclinical or early clinical studies, surrogate markers may be necessary. Skin capacitance may serve as such a marker. In our Point Counterpoint Section, Drs Goldhar and Gratton address the controversial issue of whether dermatologists should promote treatment products. There are strong opinions on both sides of this question, and these two practitioners have concisely addressed the respective sides of this issue. The Grand Rounds Section features an article by Bergman and co-authors in which they describe a case of crusted scabies in association with HTLV-1. Dermatologists are frequently faced with individuals with generalized pruritic eruptions, where scabies is frequently in the differential diagnosis. Indeed, scabies is quite common worldwide. However, crusted scabies, or Norwegian scabies, is much less common, and one clearly has to consider immune deficiencies. This report highlights the association of crusted scabies with immune deficiency. In our CME sections of this issue, we have two important articles. The first, by Dr. Sherri Bale, is a continuation of our Genetic Studies in skin disease research, and the article reviews the area of mapping of hereditary skin disease by focusing on the gene for pseudoxanthoma elasticum. In our day-to- day clinical practice, we frequently discuss the clinical diseases we see in terms of prognosis that is often based on our own individual experience. Evidence based prognostic modelling may provide a very important technique to more accurately assess our patients' outcomes. Drs. Kantor and Margolis review the models and enhance our understanding of these techniques. In this issue of the Journal we introduce a new section of structured book reviews. Two books, Morphologic Diagnosis of Skin Disease and Handbook of Dermatology for Primary Care are reviewed. The structured review provides a concise analysis of these books to allow readers to determine application of these publications to their needs. I hope that each and every one of our readers had a very happy holiday season and I wish you the best for the new year.