Dermatology Research Papers - Academia.edu (original) (raw)

On close careful examination, telangiectasia was seen on the lesion and the skin surrounding the lateral and lower part of the lesion showed mild reticular erythema as shown in Figure 2. On palpation, the lesion was non ABSTRACT We report an interesting case of an eight year old boy presenting with a depressed atrophic wrinkled plaque on cheek for last three years. The clinical finding of wrinkling and soft and pulpy consistency of lesion raised the possibility of elastolytic disorder but was ruled on the basis of normal elastic tissue on Verhoff stain. The histopathological findings were consistent with atrophoderma, but the lesion lacked the classical clinical features, thereby posing a diagnostic dilemma.

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- Dermatology

Dermatitis artefacta is a rare psychiatric condition characterized by rubbing of skin blisters and denial of self-infliction. Dissociation may be comorbid with self-injurious behavior. A background of emotional disturbances during formative years and in later life often results in feelings of isolation and insecurity, which can lead to dissociation as a primary defense mechanism used to overcome traumatic events. In this case report, we describe a female patient with dermatitis artefacta associated with dissociative identity disorder. The patient was a 14-year-old girl.

- by Oya Oguz
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- Masochism, Dermatology, Adolescent, Differential Diagnosis

Electromyography (EMG) is the subject which deals with detection, analysis and utilization of electrical signals emanating from skeletal muscles. (1) The electric signal produced during muscle activation, known as the myoelectric signal, is produced from small electrical currents generated by the exchange of ions across the muscle membranes and detected with the help of electrodes. Electromyography is used to evaluate and record the electrical activity produced by muscles of a human body. The instrument from which we obtain the EMG signal is known as electromyography and the resultant record obtained is known as electromyogram. (2)

BACKGROUND Impetigo, a highly contagious bacterial skin infection commonly occurring in young children, but adults may also be affected. The superficial skin infection is mainly caused by Staphylococcus aureus (S. aureus) and less frequently by Streptococcus pyogenes (S. pyogenes). Antimicrobial resistance has become a worldwide concern and needs to be addressed when selecting treatment for impetigo patients. An evidence-based impetigo treatment algorithm was developed to address the treatment of impetigo for pediatric and adult populations. METHODS An international panel of pediatric dermatologists, dermatologists, pediatricians, and pediatric infectious disease specialists employed a modified Delphi technique to develop the impetigo treatment algorithm. Treatment recommendations were evidence-based, taking into account antimicrobial stewardship and the increasing resistance to oral and topical antibiotics. RESULTS The algorithm includes education and prevention of impetigo, diagno...

- by Anneke Andriessen
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- Dermatology, Medicine, impetigo

Heerfordt-Waldenström syndrome is also referred to as uveoparotid fever. In our patient physical examination showed bilateral parotid gland enlargement. Chest X-ray showed bilateral hilar lymph adenopathy. Biopsy specimen from the right parotid gland revealed scattered granulomas with focal central necrosis. Stains for acid-fast bacilli and fungi were negative. He was diagnosed as a case of HeerfordtWaldenström syndrome, a rare form of sarcoidosis in which the compression of the facial nerve results in palsy. He was treated with 60 mg of prednisone daily, and at follow-up after two weeks later, the swelling and uveitis was resolved.

- by Aysha Babar
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- Computer Science, Dermatology, Medicine

Background: Current therapeutic options for atopic dermatitis (AD) are limited. Janus kinase (JAK) inhibitors may be viable alternatives. Objectives: To assess the efficacy and safety of JAK inhibitors for AD treatment. Methods: We searched PubMed, Embase, the Cochrane Controlled Register of Trials, Web of Science, Global Resource of Eczema Trials database, and ClinicalTrials.gov from inception to September 1, 2020. Randomized clinical trials (RCTs) comparing JAK inhibitors with placebo/vehicle treatment for AD patients were included. The primary study outcomes included (1) the change (%) from the Eczema Area and Severity Index (EASI) baseline expressed as weighted mean difference (WMD) and 95% confidence interval (95% CI), and (2) the Investigator’s Global Assessment (IGA) response and safety outcomes expressed as relative risk (RR) and 95% CI. Results: We included 14 RCTs published in 13 studies (3,822 patients). Treatment with JAK inhibitors significantly improved IGA response (R...

- by Vinal More
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- Dermatology, Medicine, Meta Analysis, Clinical Sciences

Miescher's cheilitis granulomatosa is the monosymptomatic form of Melkersson-Rosenthal Syndrome. Severe macrocheilitis often causes a functional and esthetical impairment of the lip. Conservative treatment represents the first option to face this rare disease. Unfortunately, medical treatment is often ineffective without any significant result as far as swelling and disfigurement are concerned. Reductive cheiloplasty is indicated in all those patients who have failed to respond to medical treatment. Excision of excess tissue may be obtained by means of several surgical techniques. We report a case of a 55-year-old man affected by severe granulomatous cheilitis refractory to any medical treatment and then treated with the use of tongue flap for the reconstruction of the excised lower lip.

- by Giampiero Girolomoni
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- Dentistry, Dermatology, Medicine

Congenital nevi are hyperpigmented macular lesions that are derivatives of the melanoblasts. Crude incidence estimates suggest that approximately 1 in 20 000 are born with a large CMN and 1 in 500 000 are born with a very large (giant) CMN. They occur in less than 1% of the neonates in any site of the body. The giant congenital nevus is greater than 20 cm in size, pigmented and often hairy. We report a classical case of large congenital melanocytic nevus present over face. The case report is being presented because of its rarity.

- by Chandra Sharma
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- Medical Sciences, Dermatology, Medicine, Nevus

Skin is the largest organ of human body and stands as a guard for our internal organs. It can be regarded as a mirror giving a reflection of metabolic, biochemical and functional status of our internal organs. Dermatologists/Gastroenterologist should be aware of the dermatological manifestations as these change may be the first clue that a patient has underlying gastrointestinal (GI) or liver disease. Recognizing these signs is important in early and appropriate diagnosis. This article reviews the important dermatological manifestation of various GI and liver diseases.

- by Manisha Nijhawan
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- Dermatology, Medicine

Hailey-Hailey (HHD), or benign familial chronic pemphigus disease, is a rare autosomal dominant blistering disorder characterized by recurrent vesicles that erode and macerate into weeping and crusting plaques. HHD has been shown to be resistant to several treatment options. Although not yet approved as a treatment for HHD, recent reports have suggested the use of low-dose naltrexone (LDN) as a successful treatment option for controlling recalcitrant HHD. We present a case of a 50-year-old woman with a 20-year history of biopsy-confirmed HHD with recurrent painful and pruritic vesicles and plaques. The patient developed significant clinical improvement of the cutaneous lesions with LDN treatment after only 26 days of treatment. It is important for dermatologists to consider LDN as a viable treatment option for HHD, especially in recalcitrant patients. We suggest this novel treatment as a rapidly effective option to resistant HHD.

- by Dylan DiSano
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- Dermatology, Medicine, Hailey Hailey disease
- by Anneke Andriessen
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- Dermatology, Medicine, Light therapy, Clinical Sciences

Dermatophilus congolensis is a bacterium that causes exudative dermatitis with scab formation in bovines. Humidity and ticks are predisposing factors. This study describes skin lesions in 27 bovines from a Simbrah herd of grazing livestock of 180 females (15%), aged 18 to 30 months old, in Aldama, Tamaulipas, Mexico. Lesions were distributed in the lower extremities, the belly and the neck and consisted of thick grayish to dark brown scabs with exudates and blood. Scabs were collected from four of the most severely affected animals, placed in sterile tubes and then transported in refrigeration to the laboratory. Samples were processed for isolate D. congolensis. The four samples revealed long branched filaments made up of coccoid cells arranged in parallel rows, one after the other, which is a characteristic of D. congolensis. In this outbreak, morbidity was 15% (27/180) and mortality was 22% (6/27). The PCR using ESP1 and ESP2 primers amplified a product between 400 and 500 bp, and the 16 s sequence was 100% identical to D. congolensis gene for 16S rRNA, strain: NBRC 105199 Sequence ID: dbj|AB550800.1|. The observation of lesions, clinical signs, identification and sequence led to this first report of bovine dermatophilosis in Mexico.

- by Adrian Muñoz Bucio and +1
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- Bacteriology, Dermatology, Molecular Diagnostics

A dermatite seborreica é uma doença eritêmato-escamativa de caráter crônico-recidivante que acomete entre 1 e 3% da população geral dos Estados Unidos. Possui dois picos de incidência - o primeiro, durante os três primeiros meses de vida, e o segundo, a partir da puberdade, atingindo seu ápice entre os 40 e 60 anos de idade. Os indivíduos HIV positivos têm maior prevalência da doença, que apresenta maior intensidade e tendência à refratariedade ao tratamento. Doenças neurológicas e outras doenças crônicas também estão associadas ao desenvolvimento da dermatite seborreica. Como mecanismo fisiopatogênico, reconhece-se que o fungo Malassezia sp., presente na pele de indivíduos suscetíveis, leve a uma irritação não-imunogênica a partir da produção de metabólitos à base de ácidos graxos insaturados deixados na superfície cutânea. Este artigo faz uma revisão da literatura sobre dermatite seborreica, com ênfase nos aspectos imunogenéticos, formas clínicas e tratamento.

- by Marcia Ramos-e-Silva
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- Dermatology, Medicine, Clinical Sciences, Seborrheic Dermatitis

The OECD guideline for studies on percutaneous penetration to be used in hazard and risk evaluations prescribes experimental conditions with optimal barrier integrity of the skin, which in many occupational settings probably is not true. Thus, workers may have compromised skin due to chemical or mechanical damage, due to different medical conditions (eczema, dermatitis, skin irritation) or related to occupational scenarios involving prolonged wet work. The present study used the OECD guideline procedures to study the in vitro percutaneous penetration through human skin of a number of model substances (glyphosat, caffeine, benzoic acid, malathion) covering a range of solubilities. Further, we studied the extent to which a slightly damaged skin would change the rate, the amount absorbed during dermal exposure and the distribution of chemical deposition between epidermis and dermis. The present study demonstrates that a limited damage to the skin significantly increases the permeability coefficient (K p) as well as total percutaneous penetration of chemicals, and most significantly for those compounds that due to their physicochemical characteristics (the most hydrophilic as well as the most lipophilic) have low penetration rates through intact skin. The present experiment not only confirms the proportionality between lipophilicity and potential for percutaneous penetration, but also illustrates that at a certain degree of lipophilicity of a model compound, the different skin compartments become more attractive for temporary deposition of model compounds. Moreover, a clear change from epidermal deposition towards a dominating dermis deposition of chemicals temporarily deposited within the skin is seen following damage to the skin barrier. Thus, the distribution of chemicals within the skin compartments is affected by the physicochemical characteristics of the chemicals as well as by the integrity of the skin. This observation may have implications when evaluating the possibility of removing chemicals from the skin through different cleansing procedures following unintended dermal exposures.

- by Flemming Nielsen
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- Kinetics, Dermatology, In Vitro, Caffeine

A new approach based on the implementation of Self Organizing Map is presented for automated detection of erythemato-squamous diseases. The purpose of clustering techniques is in order to determinate the severity of erythematosquamous dermatology diseases. The studied domain contained records of patients with known diagnosis. Self-Organizing Map algorithm's task was to classify the data points, in this case the patients with attribute data, to one of the six clusters (psoriasis, seboreic dermatitis, lichen planus, pityriasis rosea, cronic dermatitis, dan pityriasis rubra pilaris). The algorithm was used to detect the six erythemato-squamous diseases when 33 features defining five disease indications were used. The purpose is to determine an optimum classification scheme for this problem. The present research demonstrated that the features well represent the erythemato-squamous diseases and SOM algorithm's task achieved high classification accuracies. The best accuration for psoriasis 85

- by diana rahmawati
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- Biomedical Engineering, Image Processing, Dermatology, Classification

Background: Prompt identification and treatment of psoriatic arthritis (PsA) in patients with psoriasis is critical to reducing the risk of joint damage, disability, and comorbidities. Objective: We sought to estimate PsA prevalence in patients with plaque psoriasis in 34 dermatology centers in 7 European and North American countries. Methods: Consecutive patients were evaluated by dermatologists for plaque psoriasis and subsequently by rheumatologists for PsA. PsA prevalence was estimated primarily based on rheumatologists' assessment of medical history, physical examination, and laboratory tests. Results: Of 949 patients evaluated, 285 (30%) had PsA (95% confidence interval 27-33) based on rheumatologists' assessment. PsA diagnosis changed in 1.2% of patients when diagnostic laboratory tests were added to medical history and physical examination. Of 285 patients given the diagnosis of PsA, 117 (41%) had not been previously given the diagnosis. Limitations: Bias may have been introduced by lack of standardized diagnostic criteria and unbalanced recruitment based on country populations. Conclusions: In this study, almost a third of patients with psoriasis seen in dermatology centers had PsA as determined by rheumatologists. More than a third of patients with PsA had not been previously given the diagnosis. Clinical evaluation alone is often sufficient basis for PsA diagnosis, but laboratory test results may be helpful in some patients.

- by Kim Papp
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- Rheumatology, Assessment, Dermatology, Europe

The outcome of aplasia cutis congenita of the scalp, nonmembranous type, in a series of 21 Caucasian patients is reported. In all the patients the congenital skin defect healed with irregular hypertrophic scar formation.

- by Carlo GELMETTI
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- Pediatrics, Dermatology, Medicine, Infant

Background: Common warts are cutaneous viral infections caused by various strains of human papilloma virus (HPV). Their variants include filiform, periungual and pigmented warts. At present more than 200 different HPV genotypes have been detected and a periodic clinical analysis will reveal whether any new morphological variations have occurred. Methods: Hundred and ten patients with common warts were taken up for this study. Results: The clinical characteristics of 637 common warts in 110 patients were studied over a span of 1 and a half years. The age group ranged from 18 years to 72 years. Seventy six were males and 34 were females. Majority belonged to the age group of 18-30 years. The most common occupational group involved were students followed by housewives. The initial site of onset in 44.5% of patients was on the fingers. Eleven patients had atopic diathesis. Similar complaints in friends and family were seen in 30%. The most common sites of involvement for classical common warts were on the fingers and for filiform warts were on the head. 30% had association with other warts out of which 28.1% had palmoplantar warts. Conclusions: Common warts usually present as a cosmetic concern in most patients. Our study concluded that young male students are susceptible to acquiring them. Characteristics of warts in atopics did not differ significantly from non atopics. Regions most prone to contact and susceptible to trauma are the most common sites of inoculation i.e. fingers, scalp and face.

- by Malcolm Pinto
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- Dermatology

The Tahoe Basin forest consists of conifer species that release the oxygen needed for survival, serve as a habitat and food source for many animals, and replenish nutrients to the soil. Since the beginning of recorded history, conifers have been utilized for food, fuel, tools, shelter, and medicine. The abundance of trees, a variety of species, and bioactive constituents offer a sustainable option for natural medicinal use. This study explores the use of steam distilled conifers of the Tahoe Basin as a topical medicine for minor skin, muscle, joint, and nerve conditions. Traditionally, all conifer parts such as the needles, resin, wood, and cones have been used as a dermatological medicine. Many species have been studied in vitro and in vivo for potential topical therapeutic use, however, the variation of species and chemical compounds are rarely differentiated. Species of conifers include ponderosa pine (Pinus ponderosa), incense cedar (Calocedrus decurrens), pinyon pine (Pinus edulis), white pine (Pinus strobus), white pine (Pinus strobus), Sierra juniper (Juniperus occidentalis), Douglas fir (Pseudotsuga menziesii). The purpose of this study is to determine whether conifer species of the Tahoe Basin can be used as an effective dermatological therapy. While bioavailable compounds vary from species to species, location, harvest, weather, ect., species of conifers of the Tahoe basin have been clinically shown to have strong antioxidant, anti-inflammatory, analgesic, antimicrobial, antifungal, antiseptic, vulnerary, UV protective, and rubefacient benefits for the skin.

Background Overexpression of the eukaryotic initiation factor (eIF) 4E results in increased translation of mRNAs encoding proteins involved in cell cycle control, proliferation, apoptosis and angiogenesis. Phosphorylation of eIF4E is conducted by MAP kinase interacting serine ⁄threonine kinase 1 and 2, and phosphorylation of eIF4E has previously been associated with increased release of proinflammatory cytokines from keratinocytes. The actions of eIF4E are counteracted by the eIF4Ebinding protein 1 (4E-BP1). Objectives To characterize the mRNA and protein expression of eIF4E, as well as the phosphorylation of eIF4E in psoriatic skin. Methods Biopsies were collected from patients with psoriasis. mRNA expression and protein levels of eIF4E were evaluated by quantitative reverse transcriptionpolymerase chain reaction and Western blotting, respectively. eIF4E distribution was determined by immunofluorescence analysis. Results We found a significant increase in mRNA expression and protein level of eIF4E in lesional as compared with nonlesional psoriatic skin. Immunofluorescence analysis demonstrated that eIF4E was located throughout the epidermis and was primarily cytoplasmic in distribution. The level of phosphorylated eIF4E protein was found to be strongly upregulated, and 4E-BP1 expression was also increased.

- by Lars Iversen
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- British, Dermatology, Western blotting, Skin

A 66-year-old woman was referred for Mohs micrographic surgery of a basal cell carcinoma on the left upper cuta-neous lip. The tumor was cleared after one stage resulting in a defect measuring 1.4 Â 0.9 cm that did not penetrate the... more

- by Leonard Goldberg
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- Surgery, Treatment, Dermatology, Clinical Sciences

Aim This audit was designed to compare current referral practice with the Ministry of Health elective services National Access Criteria for first Specialist Assessment (ACA) guidelines, to identify specific problems, and (if possible) to improve the use of acute dermatology services. Method Information regarding referral source, information provided, urgency and diagnostic accuracy, time interval between referral and consultation date, and

- by Amanda Oakley
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- Primary Care, Dermatology, Family Practice, Medicine

Education and coaching that focuses on both somatic and psychosocial aspects, is an essential part of the treatment of patients with atopic dermatitis. These interventions are important to reinforce self-management of the patient.... more

- by VMCE Nijkerk
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- Dermatology, E-Health, Patient education, Atopic Eczema

OBJECTIVE To determine whether injection every 4 months with onabotulinumtoxinA provides longerlasting reduction or elimination of glabellar rhytides. METHODS Toxin-naive women (N = 45) aged 30 to 50 with moderate to severe glabellar lines at maximum contraction completed the study. Five sites were treated with 4 U of onabotulinumtoxinA. Participants were assessed at day 30; those with glabellar severity of none to mild remained in the study. Participants received identical treatments at months 4, 8, 12, 16, and 20, and were assessed without treatment at 24, 25, and 26 months. RESULTS Baseline physician-and participant-rated treatment responders at maximum contraction were 84% and 80%, respectively, at month 20; and 56% and 58%, respectively, at month 26. Mean changes from physician-and participant-assessed Facial Wrinkle Scale at maximum contraction from baseline to all postbaseline measurements were significant (pr.001). The percentage of participants reporting neutral (0) to couldn't be more satisfied (1 4) with their appearance ranged from 91% to 100% during months 1 to 24. At month 26, 87% of participants reported satisfaction, with appearance scores between 0 and 1 4. No adverse events were reported. CONCLUSIONS OnabotulinumtoxinA delivered for 20 months significantly reduces or progressively eliminates glabellar rhytides for up to 6 months after the last treatment.

- by Jean Carruthers
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- Surgery, Nonparametric Statistics, Treatment, Treatment Outcome

A new strategy for the skin delivery of bioactive compounds has been developed, using enzymes involved in the maintenance of the epidermal barrier function and the enzymatic transformation of corresponding precursors. This new strategy has been tested with regard to two enzymatic activities of the skin barrier: extracellular glucosidase and esterase/lipase. An analysis of the requirements for the glycosidic bond hydrolysis of any glycoconjugate by beta-glucocerebrosidase indicates that the release of the moiety linked to the glucose unit is obtained as long as the glycosidic bond being broken is not hindered, and as long as the leaving group property of the released moiety is good enough. This strategy was first applied to the release of the antioxidant delta-tocopherol. It was then extended to retinoic acid by introducing a spacer between the glucose unit and the bioactive moiety. This spacer was either a good leaving group such as hydroquinone, or a structure akin to a ceramide, n...

- by Daniel Redoules
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- Chemistry, Kinetics, Dermatology, Medicine

Background: The International Dermatology Outcome Measures (IDEOM) initiative is a non-profit organization that aims to develop evidence-based outcome measurements to evaluate the impact of treatments for patients with dermatological disease. IDEOM includes all key stakeholders in dermatology (patient, physician, industry, insurer, and government) during the process of developing such outcome measurements. Summary: Here, we provide an update of IDEOM activities that were presented at the 2020 IDEOM Virtual Annual Meeting (October 23–24, 2020). During the meeting, multiple IDEOM workgroups (psoriasis, psoriatic arthritis, hidradenitis suppurativa, acne, pyoderma gangrenosum, and actinic keratosis) shared their progress to date, as well as future directions in developing and validating Patient-Reported Outcome Measures. Updates on demonstrating efficacy in clinicals trials by the US Food and Drug Administration are also summarized. Key Messages: In this report, we summarize the work p...

- by Daniel Siegel
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- Dermatology, Medicine, Clinical Sciences

Background One of the main complications of chromoblastomycosis is lymphedema. The purpose of this study was to evaluate the lymphatic system of the limbs of patients with chromoblastomycosis using lymphoscintigraphy. It is a reliable, objective and noninvasive means of supporting the diagnosis of lymphedema. Methods Lymphoscintigraphy was performed in seven patients with chromoblastomycosis, six with lesions in the lower limb and one in the upper limb. Tc-99 m dextran was injected into the interdigital spaces of the upper or lower extremities. The qualitative parameters analyzed were the visibilization of the lymph vessels and the lymph nodes, dermal backflow, and existence of collateral vessels. All patients were treated with the association of itraconazole and cryotherapy with liquid nitrogen. Results Three out of the 14 extremities examined had lymphedema clinically, and the lymphoscintigraphy showed abnormalities in the qualitative parameters; whereas these parameters were normal in the extremities without lymphedema. During the treatment of chromoblastomycosis, a second lymphoscintigraphy exam was performed on 10 limbs and did not show any improvement of the previous lymphoscintigraphic alterations. Conclusions The qualitative lymphoscintigraphy was a reliable method to show the morphology of the lymph vessels and confirm objectively the diagnosis of lymphedema secondary to chromoblastomycosis. The association of oral itraconazol and cryotherapy did not modify the lymphatic alterations in chromoblastomycosis.

- by Marilia Ogawa
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- Treatment Outcome, Dermatology, Cryotherapy, Clinical Sciences
- by Khalid Aboud
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- Treatment, Treatment Outcome, Dermatology, Medicine

Introduction. Inflammatory lesions and erosions of the glans penis defined as balanitis or balanoposthitis constitute a disease in which the effectiveness of conservative treatment is not sufficient. Objective. To present the therapeutic efficacy of magneto-LED therapy in the treatment, and to present a patient with inflammatory lesions and erosions of the glans penis. Case report. The patient, 68 years old with inflammatory lesions and erosions of the glans penis of 2-4 years duration, was previously treated with various methods of local therapy without effect. As a result of a 32-week long magneto-LED therapy cycle, complete resolution of skin lesions with subsidence of the burning sensation during urination and reduced swelling and inflammatory erythema of the glans, as well as disappearance of the white coating and unpleasant smell, was achieved. Conclusions. Magneto-LED therapy is an efficient method of treatment of inflammatory lesions and erosions of the glans penis. streszczenie Wprowadzenie. Zmiany zapalne i nadżerkowe okolicy żołędzi to choroby występujące najczęściej u nieobrzezanych mężczyzn. Etiologia tych schorzeń nadal jest nieznana. Cel pracy. Przedstawienie możliwości terapeutycznych magnetoledoterapii w leczeniu zmian zapalnych i nadżerkowych skóry prącia i żołędzi. Opis przypadku. W badaniu wziął udział 68-letni mężczyzna z rozpoznaniem zmian zapalnych i nadżerkowych na żołędzi, u którego dotychczasowe leczenie nie przyniosło zadowalających efektów. Zabiegi wykonywano 1 raz dziennie przez 60 dni, wykorzystując aparat do magnetoledoterapii z aplikatorem magnetyczno-świetlnym RIR. Na podstawie wyników stwierdzono, że metoda ta stanowi cenne uzupełnienie leczenia farmakologicznego, gdyż daje szansę na całkowitą bądź częściową regresję objawów (pieczenie, świąd, ból), którą obserwuje się już po upływie 2-3 tygodni od rozpoczęcia terapii.

- by Aleksander Sieroń
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- Dermatology, Medicine

Background Autoimmune attack of the bulbar region of anagen phase hair follicles by CD8+ T cells and Th1 cytokines has been proposed to result in hair loss in alopecia areata (AA). The initiating stimuli are unknown. As interferon-a therapy may trigger AA, we propose that type 1 interferons are involved in the induction of disease. Objectives To compare lesional scalp from patients with AA with scalp lesions of cutaneous diseases associated with local type 1 interferon-related protein expression. Methods Lesional scalp of patients with AA, discoid lupus erythematosus, lichen planopilaris and androgenetic alopecia was examined by immunohistochemistry for expression of the type 1 interferon-inducible myxovirus protein A (MxA), the chemokine receptor CXCR3, and the cytotoxic proteins granzyme B (GrB) and T-cell intracytoplasmic antigen 1 (TiA-1). Results MxA was expressed in the intradermal and subcutaneous compartments of the hair follicle including sebaceous glands in inflammatory AA similar to lesions of cicatricial alopecia (discoid lupus erythematosus, lichen planopilaris) but not in the epidermal compartment of AA, and not at all in noninflammatory AA or androgenetic alopecia. The location of CXCR3-expressing cells correlated with MxA expression. The inflammatory cells around the hair follicle in AA included a lower number of GrB+ and TiA-1+ cells compared with cicatricial alopecia and demonstrated predominant TiA-1+ expression. Conclusions We demonstrate the expression of type 1 interferon-related proteins in the inflammatory lesions of AA. The distribution pattern of the interferon signature and cytotoxicity-associated proteins in AA differs from cicatricial alopecia.

- by Magdalena Martinka
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- Dermatology, Alopecia Areata, Clinical Sciences, T lymphocytes

To achieve photoprotection indicated on the package of sunscreen products they should be used appropriately. As previously published data documented that people usually applied much less than the recommended dose, the current study was... more

- by Adam Reich
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- Regulation, Dermatology, Adolescent, Young Adult

The aim of this study was to review the literature on quality of life among adult patients with neurofibromatosis 1, neurofibromatosis 2 and schwannomatosis, and to identify the specific aspects of quality of life that were studied and reported in this population. We also set out to report predictors of quality of life. Published research reports were included if they described quality of life in this population and met methodological quality according to a list of predefined criteria. Eight studies (7 in NF1, 1 in NF2, 0 in schwannomatosis), conducted between 2001 and 2013, met inclusion criteria. The methodological quality of the eight studies was mostly high according to ratings by predefined criteria. Most studies reported that patients with NF experience decreased quality of life when compared to the general population. Visibility and disease severity were strong predictors of skin-specific quality of life in NF1 patients. However, the majority of findings regarding predictors of quality of life were weak or inconclusive. Given the decreased quality of life in NF patients, it is important to examine more comprehensively the psychosocial factors in this population, especially in patients with NF2 and schwannomatosis. Mind body interventions that address these domains may provide comprehensive and efficacious long term treatment.

- by Vanessa Merker
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- Quality of life, Dermatology, Neuro-Oncology, Neurofibromatosis

Acrodermatitis continua of Hallopeau (ACH) is a rare chronic pustular eruption that predominantly involves the fingertips. The characterization of this disease has been confused. Some have considered it as a separate entity while others as a variant of pustular psoriasis. The presented patient simultaneously had ACH and joint lesions which were diagnosed as psoriatic arthritis. We believe that because ACH may be accompanied by psoriatic arthritis, as in this case, it could be evidence that it is a variant of psoriasis.

- by park young
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- Dermatology, The, Differential Diagnosis, Calcitriol

The management of acne in adult females is problematic, with many having a history of treatment failure and some having a predisposition to androgen excess. Alternatives to oral antibiotics and combined oral contraceptives (COCs) are required. Our aim was to conduct a hybrid systematic review of the evidence for benefits and potential harms of oral spironolactone in the management of acne in adult females. The review was conducted according to a previously published protocol. Three reviewers independently selected relevant studies from the search results, extracted data, assessed the risk of bias, and rated the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Ten randomized controlled trials (RCTs) and 21 case series were retrieved. All trials were assessed as being at a 'high risk' of bias, and the quality of evidence was rated as low or very low for all outcomes. Apart from one crossover trial that demons...

- by Alison Layton
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- Dermatology, Androgens, Acne Vulgaris, Systematic review

Liver cancer accounts for 4.7% of all newly diagnosed cancers and 8.2% of cancer deaths annually. Hepatocellular carcinoma (HCC) accounts for the majority of primary liver cancers. There are 2 curative strategies in HCC: resection and transplant. Unfortunately, 50% of patients who undergo resection will relapse in 2 years and many patients on transplant lists become ineligible for transplant due to disease progression. The majority of patients still require systemic therapies. Tyrosine kinase inhibitors have successfully extended the overall survival in patients with hepa-tocellular carcinoma. However, these treatments have been noted to cause severe side effects including liver toxicity, hypertension, gastrointestinal toxicity and cutaneous adverse effects. This article will focus on the adverse skin reactions seen during the treatment of hepatocellular carci-noma by various tyrosine kinase inhibitors. The focus will be symptomatology, management, and whether the development of cutaneous toxicities can be prognostic.

- by Hepatoma Research and +1
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- Dermatology, Hepatology, Gastroentrology & Hepatology, Toxicity

Background: Leprosy, also known as Hansen's disease, is a chronic, infectious and treatable disease that primarily affects the skin and the peripheral nerves. Clinico-histopathological correlation of leprosy case assumes a pivotal role in early diagnosis and proper labeling of a case and thus leads to better management of patients. Aim: To study the clinical and histopathological correlation among leprosy patients attending a tertiary referral centre in this post elimination era. Materials & Methods: Study was conducted at a tertiary hospital during July, 2014 to June, 2015. Total 72 new cases of leprosy were selected purely on clinical ground (WHO criteria) attending dermatology OPD. Then these patients were subjected to slit skin smear examination and skin biopsy. Histopathological classifications of sections were done on the basis of the scheme put forth by Ridley (1974) and later it was correlated with the clinical classification across the Ridley-Jopling spectrum to evaluate the concordance among two. Results: Both clinically and histopathologically, BT constituted the predominant group 52.80% and 41.66% respectively. The overall clinico-histopathological correlation was seen in 41 cases (56.94%). Maximal concordance was noted in indeterminate leprosy (100%), followed by polar forms of leprosy i.e. LL (80%) & TT (75%). The least concordance was seen in mid-borderline leprosy (16.66%). Conclusion: This study highlights the importance of histopathological examination in assessing the leprosy cases as the under-treatment of MB cases will lead to persisters in the community and thus spread of disease and possible danger of drug resistance too in this era of elimination.

Skin diseases are common all over the world with high prevalence
in developing countries with significant socioeconomic and
behavioral impact. In Nepal it is the fourth leading cause of nonfatal
diseases. A community clinic is the term used for a specialist
clinic provided in a Primary Care setting. The aim of these clinics
in Nepal is to improve access to basic health services including
family planning, child health and safe motherhood. But there are
no policies for dermatological diseases in the rural communities.
As skin diseases do not usually cause mortality, it is often ignored.
But the morbidity is often high and the impact on quality of life
is also high. Conducting regular skin camps at inaccessible parts
of the country is a good way to provide service to the people of
the community and due to the fact that most skin conditions can
be diagnosed visually, the method of tele-dermatology can be
successful.
Keywords: Community dermatology, Skin diseases, Nepal, Health
camps, Tele-dermatology

- by EJMS Europasian Journal of Medical Sciences
- •
- Dermatology

Background: The skin score, a subjective assessment of skin elasticity, is widely used in patients with systemic sclerosis. Although this scoring method is regarded as a validated and accepted tool, the interobserver and intraobserver reproducibility is relatively poor. Objective: Our purpose was to investigate whether the recently developed SEM 474 cutometer, which exerts a controlled vacuum force to the skin, can measure skin elasticity more objectively than the skin score. Methods: Skin elasticity was measured in 74 different body areas in patients with systemic sclerosis and compared with the skin score obtained from the same areas. Results: The cutometer produced quantitative and reproducible data. A large-diameter (8 ram) measuring probe was superior to a small probe. The interobserver intraclass correlation coefficient (ICC) was 0.92; the intraobserver ICC was 0.94. A linear correlation was found with the clinical skin score; the Spearman rank correlation test was 0.69. Conclusion: The correlation with the skin score was reasonable, despite the observation that regional differences in skin elasticity were detected by the cutometer but not by the human observer, who automatically compensates for these factors and integrates them into the skin score. The high interobserver and intraobserver ICC makes the cutometer more suitable for quantifying changes in skin thickness than the subjective skin score. (J Am Acad Dermatol 1996;35:381-7.) From the

- by Patrick Bossuyt
- •
- Dermatology, Linear models, Elasticity, Systemic sclerosis

Less than 20 of the hundreds of carotenoids found in nature are found in the human body. These carotenoids are present in the body from the foods or dietary supplements that humans consume. The body does not synthesize them. Among the carotenoids present in the body, only lutein and its coexistent isomer, zeaxanthin, are found in that portion of the eye where light is focused by the lens, namely, the macula lutea. Numerous studies have shown that lutein and zeaxanthin may provide significant protection against the potential damage caused by light striking this portion of the retina. In the eye, lutein and zeaxanthin have been shown to filter high-energy wavelengths of visible light and act as antioxidants to protect against the formation of reactive oxygen species and subsequent free radicals. Human studies have demonstrated that lutein and zeaxanthin are present in the skin, and animal studies have provided evidence of significant efficacy against light-induced skin damage, especially the ultraviolet wavelengths. Little was known about the protective effects of these carotenoids in human skin until recently. This article reviews the scientific literature pertaining to the effects that lutein and zeaxanthin exhibit in the human eye and skin.

- by Justin Green
- •
- Animal Studies, Dermatology, Free Radical, Reactive Oxygen Species
- by Jesus Sánchez
- •
- Pain, Dermatology, Capillaries, Clinical Sciences

Skin diseases are among the most common health problems worldwide. In this article we proposed a method that uses computer vision based techniques to detect various kinds of dermatological skin diseases. We have used different types of image processing algorithms for feature extraction and feed forward artificial neural network for training and testing purpose. The system works on two phases- first pre-process the colour skin images to extract significant features and later identifies the diseases. The system successfully detects 9 different types of dermatological skin diseases with an accuracy rate of 90%.

- by Nova Ahmed
- •
- Computer Science, Artificial Intelligence, Medical Sciences, Computer Vision

KOH is known to penetrate deeply and destroy the skin because it dissolves keratin. [5] Ten percent potassium hydroxide (KOH) solution has been prescribed for mollusca to be applied at home and has the added advantage of being relatively painless. Recently, imiquimod, a topical immune response modifier, has been successfully used in the treatment of external anogenital warts. [6-8] Mechanism of action is the induction of cell-mediated immunity, which helps in the regression of mollusca-similar to that observed in viral warts. [9,10] The principal antiviral cytokine, interferon-γ (in addition to other inflammatory cytokines), is induced by imiquimod cream. The aim of this study was to evaluate and compare How to cite this article: Metkar A, Pande S, Khopkar U. An open, nonrandomized, comparative study of imiquimod 5% cream versus 10% potassium hydroxide solution in the treatment of molluscum contagiosum.

- by Uday Khopkar
- •
- Tropical Medicine, Treatment, Treatment Outcome, Dermatology

To evaluate the clinical complaints, laboratory data, treatment, and follow-up of patients with delayed adverse effects related to polyalkylimide implants (PAIs). Design: Prospective case series of patients injected with PAIs. Setting: A university tertiary teaching hospital. Patients: A prospectively acquired series of 25 patients with severe and/or persistent delayed adverse effects after PAI injection. The patients underwent clinical follow-up, a battery of blood tests, and when possible, biopsy and chest radiography. Main Outcome Measures: Clinical evaluation of granulomas, skin manifestations, and other local and sys-temic immune-mediated disorders possibly related to PAIs. Results: The average latency period for onset of symptoms was 13.4 months. Eight patients were previously injected with another implant. Tender inflammatory nodules were seen in 24 patients. Systemic or distant manifestations appeared in 6 cases. Laboratory abnormalities were found in 20 cases. After an average of 21.3 months of follow-up, 11 patients appeared to be free of adverse effects, and 10 still had recurrent bouts. Conclusion: Although infrequent, delayed and recurrent chronic inflammatory and granulomatous reactions may complicate PAI fillers.

- by Jaume Alijotas-reig
- •
- Inflammation, Dermatology, Polyamines, Prospective studies

We report a case of severe contact urticaria with systemic involvement resembling an anaphylactic reaction, following the application of a topical corticosteroid. This was caused by hexylene glycol, an excipient in the formulation. Glycols are widely used in cosmetics, foods and topical and systemic drugs. In particular, glycols are present in many topical drugs used by dermatologists. To our knowledge, this is the first case in the literature of a potentially life-threatening immediate-type reaction in the context of a contact urticaria syndrome due to hexylene glycol. The classification of contact urticaria syndrome and the allergenic potential of glycols are reviewed. Dermatologists should be aware of the contact urticaria syndrome and of the increasing use of glycols in topical drug formulation in order to identify possible adverse reactions.

- by Andreas Bircher
- •
- Dermatology, Drug Use, Case Report, Anaphylaxis

To anticipate daily environmental changes, most organisms developed endogenous timing systems, the so-called circadian (B24 hours) clocks. Circadian clocks exist in most peripheral tissues and govern a huge variety of cellular, metabolic, and physiological processes. Recent studies have suggested daytime-dependent variations in epidermal functions such as barrier recovery and pH homeostasis. However, a local circadian clock in epidermal keratinocytes has not been reported yet, and as such the molecular link between the circadian system and epidermal physiology remains elusive. In this study we describe a functional cell autonomous circadian clock in human adult low calcium temperature (HaCaT) keratinocytes. Using live-cell bioluminescence imaging and mRNA expression time series, we show robust circadian transcription of canonical clock genes in synchronized HaCaT keratinocytes. Genetic and pharmacological perturbation experiments as well as the phase relations between clock gene rhythms confirm that the molecular makeup of the HaCaT keratinocyte clock is very similar to that of other peripheral clocks. Furthermore, temperature was identified to be a potent time cue (Zeitgeber) for the epidermal oscillator. Temperature cycles entrain HaCaT keratinocytes, leading to the identification of rhythmic expression of several genes involved in epidermal physiology such as cholesterol homeostasis and differentiation. Thus, we present HaCaT keratinocytes as an excellent model to study the regulation of keratinocyte physiology by the circadian clock in a simple yet robust in vitro system.

- by Thomas Blatt
- •
- Genetics, Time Series, Dermatology, Environmental Change

Background. Pediculosis capitis is a worldwide problem. We studied the prevalence ofthis infestation in Istanbul, Methods. We reviewed the records of the Dermatology Clinic of istanbul University Cerrahpa §a Medical Faculty from a 20-vear period (1970)(1971)(1972)(1973)(1974)(1975)(1976)(1977)(1978)(1979)(1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989),

- by Nahide Onsun and +1
- •
- Dermatology, Clinical Sciences, Public health systems and services research