Internal Medicine

0521779407-C01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:53

Chediak Higashi Syndrome Cholangiocarcinoma 299

■Accelerated phase: treated with vinca alkaloids and glucocorticoids,

but often responds poorly

Cheilitis...........................................

SOL SILVERMAN JR, DDS

history & physical

■chronic cracking, scaling of vermilion border

■often asymptomatic when mild

tests

■none

differential diagnosis

■allergic response (erythema multiforme)

■actinic cheilitis with dysplasia, carcinoma

■candidiasis (scraping, antifungal trial)

management

■keep lips lubricated, e.g. vaseline

■sun screen

specific therapy

■topical, systemic corticosteroids

follow-up

■for control

complications and prognosis

■chronic, recurrent nature; lubrication

■monitor for dysplasia, malignant transformation

Cholangiocarcinoma..................................

SUSAN A. CUMMINGS, MD

history & physical

History

■average age 60 yr; males >females

■more than 20% associated with PSC, usually after 10 yr of disease;

85% with pancolitis; can occur after

➣colectomy